THE FUTURE OF HEALTH CARE
Rep. Mike Morley
Twenty-five years ago, with the birth of our first son very near, my wife and I were concerned that we didn’t have health insurance. I visited with our family doctor and we agreed to a trade for services – the delivery of my baby for construction work on his home. I next approached Mountain View Hospital and asked what the cost would be for the birth of our baby. They were surprised. It seemed no one had ever asked that question before. So, over the next hour or so, we discussed several options – a 24-hour stay, a regular delivery with no complications, payment upon leaving the hospital, etc. – and we were able to agree on a price. The delivery went just as planned and 24 hours later as we were leaving the hospital, I paid with a check marked “Paid in Full”. Six weeks later, we received a bill from the hospital showing their normal and customary cost of services which was about three times what I had paid. I took my canceled check back to the hospital, reminded them of our agreement, and left with the balance of the bill having been written off.
For at least the past couple of decades, the health care system in Utah and in the United States has been controlled by health insurance companies, government mandates, and layer after layer of bureaucracy. Most consumers spend more time shopping for shoes than they do for health services simply because all of the decisions about doctors, procedures, hospitals, and treatments have been made by whatever insurer we have chosen. Our preferred doctor or the closest hospital may be just around the corner, but if they are not approved providers or facilities for our health plan, they are not an option. Consumers must have choices and flexibility. We should be able to shop for health care much like we shop for home or auto insurance with options, variable deductibles, and coverage which can be increased or decreased depending on need. We need more flexibility for such things as a la carte services, health savings accounts, and using pretax dollars to pay for health care. We need expanded risk pools so small businesses are not at a decided disadvantage. We need personal accountability for unhealthy behaviors which increase risk.
In the 2007 General Session, I sponsored HB 9 Health Care Cost and Quality Data which established an online database to which health care providers post information on the cost of a specific procedure or episode of care and report on the outcome for each. This single bill has stimulated conversation and been a catalyst for health care reform in Utah. Just this past session, the legislature established a task force which is pulling together the best minds from government, the business community, health care providers, medical professionals, and insurance companies to look at this issue in depth and make solid recommendations. I am optimistic that positive, substantive changes in the health care system in Utah will result.
Recently, the Salt Lake Chamber of Commerce published a vision statement for the future of health care which reads, “We envision a health care system that will sustain a vibrant economy and enable people to live healthier, more productive lives. In such a system, every Utahn will have access to affordable, basic health insurance and care that is paid for with pre-tax dollars, chosen by the employee, portable from job to job (or for the self-employed), guaranteed issue, rated based on a broad-based risk pool and structured to incorporate cost controlling features. Health care consumers will have access to complete information that will allow them to make prudent decisions about their care and employers can make defined contributions to the health care of their employees. In such a system, we will increase accountability, eliminate waste, transform incentives, extend compassion and, most importantly, improve people’s lives.” This vision of a portable, flexible, market-driven health care system is one I have long advocated and is far superior to the government-mandated entitlement system being widely discussed on a national level.
A few weeks ago, my son and his wife realized that their insurance would not cover the approaching birth of their first son. So, together we visited Mountain View Hospital to discuss the costs for the birth of their baby. Our experience bore little resemblance to my visit some 25 years earlier. This time, we were presented with a cost sheet detailing prices and services from which he could choose varying levels of care. Certainly, it is just one step, but it is a step in the right direction. This is my vision of the future of health care in Utah.
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