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Tuesday, May 02, 2006

Time for some answers

By Senator Gene Davis
Democrat, Senate District 3

I am posting here today because of the recent articles that I have read regarding the increased costs of healthcare; consolidation or merges among the insurance industry has tended to monopolize the market place.

Senator Wadoups and I have had discussion about these issues. As the Privately Owned Health Care Task Force begins it’s second year of looking at our health care system. We believe it is time to investigate the competition and exclusion of providers in our system.

When more and more individuals are losing coverage or have to meet astronomical first pays or co-pays just to see a doctor to receive medical attention then something must be done. The healthcare system is broken and part of the problem is patient choice and access to affordable healthcare. We think there is a role for all providers.
What are the factors behind the double-digit healthcare inflation?

What are health insurance contracts predicated upon?

Why is the cost of health care so high?

Is there any kind of conspiracy between the insurance industry and some providers?
We need answers and so I am joining with Senator Wadoups in calling for an audit and investigation into these issues on both the Federal and State level.

10 Comments:

Anonymous Jonathan P. said...

Oh, PLEASE Sen. Davis! Tell me you're not another "conspiracy theorist"! How naive of you to think that the problems in healthcare are due to patients not having enough choice in physicians (and surgical centers?)! That's simply a ploy used by some physicians (especially those who own surgical or imaging centers) to try to convince you they should be on any insurance provider's panels they want to be on. In reality, it has little to do with patient choice. It's PHYSICIAN choice, convenience, and greed that's in play here. Granted, there are large companies who seem to pay their executives large sums of money. This is not uncommon in the world, however. And if it seems inappropriate to consumers and employers, THEY will respond by taking their business elsewhere.

Our U.S. healthcare system is unique, and I think it will take unique solutions to solve problems with it. I don't think Americans will put up with systems like the UK and Canada.

In our system generally and certainly locally, there are no conspiracies, only typical business practices, such as contracts, to provide insurers with access their customers need and providers with volume they desire. This is typical in free markets, which I hope you still believe in. Most insurers have multiple products: some with large choice of physicians and facilities, some with fewer. It's not about limiting care, it's about providing options to customers. To those who are less worried about many choices, they can choose the plan that suits them (which will also cost less). For those who want more choices, they can choose that plan (which will cost more). If you don't yet understand why the plans work this way, I suggest YOU educate yourself before calling for all kinds of frivolous investigations before the ones this state is involved with currently are even concluded!

If you don't mess with it, the market will take care of the problem. Part of the problem is there's already too much regulation in business (and healthcare). Let's try to to mess it up any further by pursuing a path of blame, intimidation, and cries of conspiracy.

5/03/2006 9:19 AM  
Anonymous Anonymous said...

Another apologist who is probably an employee of the hospital association, system or insurance industry. Tell working families in Utah who are struggling that access to affordable care is a "conspiracy theory"........

5/03/2006 10:31 AM  
Anonymous Anonymous said...

as lifelong democrat, I want to congratulate Senator Davis for joining Senator Waddoups in the effort to truly help working families and small businesses. The outrageous profits of the insurance industry and hospital systems in this state, truly underscores the problem.

5/03/2006 10:33 AM  
Anonymous ds said...

The DOJ and FTC ALREADY did a study. 27 days of hearings, testimony from 250 panelists, and 6,000 pages of transcripts. They said that the problems are: 1) too many government regulations on the industry, 2) 3rd party payors distort incentives, 3) lack of transparency with price and quality information, 4) the economic "Iron Triangle" of cost, quality, and access in healthcare (as one or two of those gets better the other one or two must get worse), and 5) societal views of healthcare (entitled benefit concept).

Fix those and you'll fix the problem. Focus on scandal and collusion and you may gain attention, but will never fix the problem.

5/03/2006 11:41 AM  
Anonymous Anonymous said...

I believe the biggest issues cost, and choice can be alleviated in two ways. First an effective model like Massachusetts that will get the uninsured coverage so that we who are insured can stop paying those costs associated with health care. Second people need to understand that more choice is possible but it will NOT cost less it will cost more, in the history of a free market there are very few instances of getting more for less. If people want more choice they will need to pay higher premiums.
Finding a way to get all Utahns some type of coverage is more important and will reduce costs for the entire system.

5/03/2006 12:26 PM  
Anonymous Dee Quan, R.T. said...

I work in a hospital and I see that most people are abusing the system. They are doing this by coming into the Emergency Room for non emergency situations. These are the people that do not have insurance and the people who don't bother to learn that there are places to go like urgent care facilities and not go to the emergency room where the cost is high. I wish that everyone could have insurance but I would hope that they get educated as to how to use it. Another reason is having people that are not trained properly in various places of the hospital and having exams repeated . This brings healthcare up. There are also those bonuses that are paid to the CEOs when some of it could be put back into healthcare for those that do not have it. A lot of the money paid by those that have insurance is going to those immigrants that come into the hospital for little things as colds, coughing, etc, etc. Come to the hospital especialy the emergency rooms and see for yourselves. Have you ever experience this? Come see what it really is. Dee Q

5/03/2006 1:30 PM  
Blogger RH said...

I work in a hospital too, and I agree that the ER is abused. But the ER can't turn anyone away or even refer the to an urgent care center or they are breaking the law. I would love to tell someone that they can go to the urgent center across the street and get faster care for less money, but I'd be violating the law and probably get fired. This is an excellent example of over-regulating health care. And why do we need so many regulations? For profit hospitals. They have been scamming patients for years and dumping those wihtout a way to pay on the not for profits because they won't be turned away. It is greed that caused these problems. Get rid of the profit status and many of them disappear.

5/03/2006 1:47 PM  
Anonymous Anonymous said...

Senator Davis,

Can't you see there is a problem with a few arrogant attitudes of some doctors who think they need more money...as if 6-figure incomes are not enough?!

Surely we can agree there is a level of ego-mania involved with a certain few physicians. It's all about wealth accumulation!

I do not sympathize with doctors who aren't included on certain panels. Probably because either they are lousy doctors, or are too greedy to get on a good panel.

Sorry, but that's what I think!

I admire doctors who serve others like "Doctors without Borders" who joined the many medical volunteers throughout the world to make a difference -- not expecting a dime!

Again, I think this issue is a problem based solely on modern-day greed.

5/03/2006 2:06 PM  
Anonymous L.MASON said...

I would like to believe that an investigative process could in fact initiate changes in such a massive and complex problem as health insurance. I hold a pessimistic view of such because I think the expectations of individuals are unrealistic. Frankly there are some things that nature should be allowed to do---we intercept much of that process with the demand for medical treatment "at any and all cost". I do not propose to have an answer to the problem but I think every individual has a responsibility to determine what they are willing to contribute. The demand for highly technical testing and pharmaceutical medication is generated by the public. How many unnecessary visits to medical facilities are there? I am not opposed to treatment when there is a genuine need but I am opposed to medical visits for every cough, fever, ache, pain, and mental stressor. The idea of getting something for nothing should apply to the healthcare industry as it applies in other areas of our lives. I believe we need to be more resopnsible about what we request from healthcare. The issue of liability for providers is such that I belive they are forced to refer patients for expensive testing when it is not truly necessary but the potential liability of not doing so forces their hand.
Profits and monopolies? Let's have at Questar, Pacificorp & the oil industry.
I do have a point of reference in that my spouse was a terminal patient for a number of years. The astronomical costs even with health insurance led to personal bankruptcy. There is indeed a reason to define quality of life. A system that supports aborting a fetus and subsequently fights to keep a 26 week neonate alive at all cost is a system of contradiction. As long as there is a paying public for face lifts and tummy tucks, the demand for every kind of helath care will not diminish. Good luck. I hope an investigation will address these issues but my supposition is that it will only support the political motivations of those doing so.

5/03/2006 2:28 PM  
Blogger M. Albert said...

Many long comments, haven't had a chance to read them all but I thought I'd ask this question. "Health Care" as a whole is quite a number of industries. Patient care, pharmaceuticals, and the miriad of equipment and disposables and the storage of those disposables etc. etc. etc.

Senator Davis has opted to focus on one specific area, the insurance industry. "Why?" he speculates "is it so darned expensive" the conclusion he has alluded to is collusion. That it's some kind of plot, a conspiracy of fat cats preying on the sick.

Almost every single piece of the "health care" puzzle is provided by for profit companies. These companies have responsibilities to thier share holders, and thier employees to turn a profit. If they don't the share holders are out the money invested and the employees will eventually be out of a job.

There are exceptions, there are pieces that are provided by companies and hospitals that are not for profit. Senator Davis and Senator Waddoup have chosen to focus on trying to kill the very thing they claim to want. The question we should ask ourselves is "Why?" Why are they going about things in this way. Why do they claim to be looking out for our interests by taking away, or breaking up one of the few proven ways to provide healthcare without trying to line the pockets of share holders? Why do we allow them to do something who's only beneficiary would be the very people that Senator Davis implies is part of a conspiracy? Why are these men making decisions for us?

Why would we vote for them or anyone who thinks like them ever again?

5/04/2006 6:04 PM  

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