Last Tuesday I had the opportunity to attend the Utah Health
Policy Project’s Conference, titled, “Is It Working? – Taking the Pulse on
Health Reform in Utah.” It was a great
conference with way too many key messages to cover in a short blog post, so I’ll
cover the ones that spoke to me.
The morning keynote speaker, Mr. Rick McKeown, began with
the message is that we solve common problems when the common pain is
sufficient. He addressed the many forces
that are driving health care reform in our nation. His list of eight pressures follows:
1.
Economics – recovery from the recession, job stagnation
2.
Demographics – aging boomers, obesity and chronic illness
3.
Consumers – we’re demanding transparency in our health care costs
4.
The Affordable Care Act
A. Access to health care
B. Regulating the insurance industry
C. Defining benefits
D. Medicare and Medicaid improvements
E. Uncertainty and unintended consequences
F. Politics
5.
Judicial – the debate between state and federal exchanges causing more
uncertainty
6.
Employers – transitioning from a defined benefit to a defined
contribution
7.
States – looking for autonomy and the ability to craft solutions that
fit their populations
8.
Reconfiguration of risk – outcomes vs. services
Is this enough common pain?
Are we there yet?
Disclaimer: I
consider myself fairly liberal and am glad of the health care reforms brought
about by the Affordable Care Act. I live
in a fairly – OK, I live in a very conservative
state where most of the leadership is less than impressed with the Affordable
Care Act. That said, liberals and conservatives
came together at this conference, leaving their egos at the door, to discuss
real solutions for real people. A panel
of those real people spoke to us, giving us hope that the solutions in place
are working for some.
Lynn Quincy, Associate Director of Health Reform Policy for
Consumers Union, gave us tips for getting the value from our health insurance,
confirming the idea that we need to become intelligent consumers of health care
services. She noted that this has been
difficult because of the current model of health care delivery. I've experienced this myself – when nobody
could tell me the price of an x-ray.
The liberal in me was exposed to a new perspective when the “Healthy
Utah” plan to address the coverage gap was presented. People who fall below 133% of the federal
poverty level currently fall into the coverage gap in the states that opted not to expand Medicaid. Because they should have been covered by the
Medicaid expansion, they are not eligible for subsidies to assist with buying
private insurance on the marketplace (healthcare.gov). Utah’s solution, as I understand it, is to
use federal dollars that would have been given to the state for the Medicaid
expansion to provide subsidies for Utahns that fall into the coverage gap. The upside of this plan – one I had not
considered – is that it removes the stigma of being on Medicaid as well as
opening up better choices for health care.
A privately-issued insurance card opens more doors to services than a
Medicaid card. The plan was well
received by the conference attendees.
Now – on to the Legislature for approval.
Is the health care reform law working? Not perfectly, but it’s a start. And I am hopeful that in the State of Utah,
well known for its innovative approaches to quality health care, it will
continue to improve.
