A Healthier
Oklahoma - It Could Happen With the Right Reforms
The Sunday Oklahoman,
Editorial
January 9, 2000
Health care analyst Grace-Marie Arnett is
offering what's been labeled "a fresh approach" on health care reform.
Her ideas are fundamental common sense in an area that often makes
little sense. Arnett recently visited Oklahoma to speak before a
legislative panel and to visit the editorial board of this
newspaper.
The Oklahoman advocates deposit of tobacco
settlement funds into a trust - with interest payments bolstering health
care. Still, we hope that all new dollars for government-financed health
care will be spent more wisely than in the past.
Oklahoma's poverty, relative to the rest of
the country, makes problematic both government and private efforts to
improve access to affordable health care. Arnett, who runs a public
policy organization in suburban Washington, said past "reforms" have fed
dubious outcomes: "For decades, state and federal legislators have
created and expanded government entitlement programs and imposed more
and more regulation on the health sector. Yet the number of uninsured
continues to rise, reaching 44 million last year, according to the
Census Bureau."
The General Accounting Office, she noted, has
"studied the states that were most active in passing health insurance
regulations affecting their individual and small group markets. These
states mandated what insurance must cover, to whom and when it must be
sold, and what the premiums could be."
Arnett said that the Galen Institute she
runs, working with the Heritage Foundation, "looked at the experience in
the early 1990s of 16 states that had been identified by GAO as having
been most active in passing regulations. Unfortunately, the efforts
backfired. Regulations to require insurers to sell policies at
politically determined prices with mandated benefits and guaranteed
access to insurance - even if people wait until they are sick to buy
coverage - had the effect of driving up prices and driving health
insurance out of reach for more and more of their citizens."
Obviously, "Legislators who design Cadillac
plans when most people can afford only a Ford condemn their citizens to
going without coverage at all. We found that the uninsured rates in the
16 states that were the most aggressive in passing health insurance
regulations rose eight times faster than the other states the year after
all the regulations went into effect." Good news: Oklahoma was not among
the 16 states that moved so foolishly. Bad news: A strong constituency
for such misguided action exists in the state Legislature.
Arnett has an essay in the January 2000 issue
of Perspective, a publication of the Oklahoma Council of Public Affairs.
A note accompanying Arnett's piece hailed Labor Commissioner Brenda
Reneau Wynn for being "on target in wanting to use interest earnings to
help Oklahoma's working poor obtain better health care services."
Arnett's study "points the way," the council said, to practical policies
supporting the commissioner's approach. State Treasurer Robert Butkin,
Attorney General Drew Edmondson, Lt. Gov. Mary Fallin, Senate President
Pro Tem Stratton Taylor, House Speaker Loyd Benson and other supporters
of the trust fund could profitably mine Arnett's works for policy ideas
to bulk up such ideas. This could positively impact availability of
health care for those who are willing to work but whose resources are
stretched by the cost of private insurance. This seems like an unusually
good opportunity for diverse interests to work for a common policy
goal.
Arnett said in all her work that real
progress in helping the poor could come, among other things, through
reforms aimed at creating our own version of the State Children's Health
Insurance Program. This program works with private providers to bring
benefits to the poor, using vouchers and other devices to make coverage
accessible. Other reform ideas include tax credits for workers who
purchase their own coverage - an idea supported by the White House and
Congress - and market-oriented reforms in Medicaid.
Such sensible, market-driven approaches to
resolving difficult questions of health care, insurance and access
deserve serious consideration.
© The Oklahoma Publishing Co. and its
subsidiary, Connect Oklahoma Inc.