Delaware Legislature Should Support Health Care Choice, Group Says

The Delaware-based Caesar Rodney Institute calls for that state’s legislature to adopt the Freedom of Choice in Health Care Act.

Here’s what it said in an e-mail sent out yesterday:

Instead of waiting for the U.S. House and Senate to merge the two health care bills into one, the Delaware General Assembly can take action when it returns to session tomorrow [January 12] to help protect choice in American health care.

Already introduced in over a dozen states, the Freedom of Choice in Health Care Act is model legislation from the American Legislative Exchange Council that seeks to “protect the rights of patients to pay directly for medical services, and it prohibits penalties levied on patients for declining participation in a particular health plan.”

The legislation was discussed in a recent New York Times story.

Delaware should join the growing list of states that consider this legislation and move towards protecting choice in health care.

The idea of state legislators pursuing such an undertaking may appear to be quaint in this age of trillion-dollar national spending bills. But such efforts send powerful political signals.

Delaware Officials Fail People in their Care

There’s one group of people who currently have a “right” to government-paid health care: prisoners. So how does “free” health care work for them?

The Caesar Rodney Institute, a Delaware-focused think tank, says that the state’s department of corrections has a lousy record in providing health care to prisoners. In fact, it’s not just the think tank’s opinion; the U.S. Department of Justice has said the state has effectively violated the civil rights of inmates. Now it monitors the department of corrections.

The institute has documented problems caused by the state’s malpractice. For example, one man lost his legs to complications from diabetes after prison officials failed to properly monitor or treat his diabetes.

Instead of addressing problems, the state is circling the wagons. The institute says, for example, that the office Attorney General Beau Biden (the vice president’s son) has stifled critics of the department of corrections.

Not all government offices are corrupt or as poorly run as the Delaware DOC. But the story from Delaware should be a cautionary note against turning even more responsibility for and power over health to government.

Delaware Drug Dispute Settled

The state of Delaware decided to cut its pharmacy reimbursement rate in its Medicaid program, causing Walgreens to threaten to drop out. (The company said it would lose money on filling Medicaid prescriptions as a result of the cuts.)

In turn, one legislator threatened to drop Walgreens from the state employees health insurance plan. The trade associations for pharmacies in turn talked of a lawsuit against the state, alleging a violation of state and federal laws.

Now they've dropped their claims.

The good news? "The action means Delaware Medicaid patients can continue to fill prescriptions at the pharmacy of their choice."

The state will now pay slightly more for brand-name drugs than it had planned, and slightly less for generics.

One in five state residents is on Medicaid, so the state has plenty of weight to throw around. It's not a case of keeping private companies as much as it is sticking it to them.

When politicians use their "market" clout in purchasing medical services, they will distort the market. It will be interesting to see what happens next.

Empower People, Not Insurance Companies

The Caesar Rodney Institute says that in the health reform debate, we should ask "If Americans were starting from scratch with establishing a health care insurance framework in America, what would we want?"

It's not that we can actually start from scratch, the institute says. But rather, it focuses the mind.

The Delaware-focused institute says:

America wants a health care system that is more affordable; offers more choices; is less confusing; expands access beyond what is currently provided; provides options for those with pre-existing conditions, the elderly and the poor; does not infringe on patient choice; and does not create a massively expanded federal bureaucracy that is too costly and ineffective.

It lays out some ideas in a nine-page report (PDF) that starts with the assumption that "individuals, not the government and not the insurance companies should control health care."

Delaware Expands SCHIP Outreach

Critics of yet more government health care programs and health care regulations say that many of "the uninsured" are already eligible for a government program, but have not signed up.

Delaware will be handing out money to non-profit groups that seek to get people eligible for SCHIP to sign up.

I suppose it's a sign of progress for us to make one government program "work" before starting another one.

U.S. Index of Health Ownership 2nd Edition Is Here

Pacific Research Institute has published the 2nd edition of the U.S. Index of Health Ownership, the only ranking of health care in the states that uses criteria of individual choice.

Americans lack the basic freedom to make their own health care decisions. The Index measures the degree to which individuals, be they patients, health professionals, entrepreneurs, or taxpayers, “own” the health care in their states.

The lack of health ownership is a real problem. Almost half of the country’s health care spending is in the hands of the government, instead of patients themselves. The other half is governed by regulations inflicted upon doctors, health plans and patients.

The Index uses 24 variables to quantify how state laws and regulations affect the liberty of citizens involved in state government health plans (primarily Medicaid), the private health-insurance market, and the provision of medical services. It also assesses the effect of medical tort on people’s freedom to engage health services.

Alabama, Montana, Nebraska, North Dakota, and New Hampshire finished in the top five, as the states that allow their citizens the highest degree of health ownership. Alabama leads the pack primarily because of a lightly regulated private insurance market, and good control of state government programs. Also, the state performs well on medical tort indicators. Alabama’s regulatory environment for providers favors competition, and government health programs run more effectively than in most states.

New York, Massachusetts, Rhode Island, Vermont, and North Carolina rounded out the bottom five, as the states in which the government has taken the most undue control of health care from its citizens. This is the second year that New York was in last place. The state suffers from government health-care programs that are out of control, a grossly overregulated private-insurance market, and almost completely uncompetitive provider markets.

A full listing of all 50 states and their rankings is contained in the Index.

The Index will give concerned citizens a good basis to demand reforms from their state politicians that will put American families in charge of American health care, instead of government and special interests.

Tit for Tat in Delaware Dispute Over Prescription Drug Prices

Can a state government force a vendor to "sacrifice?" The fight between the state of Delaware and Walgreens continues.

The state had previously announced a unilateral cut in the reimbursement rate it would pay for drugs purchased by people in the Medicaid program. Walgreens decided to withdraw from the program. (See here and here for previous installments.)

In retaliation, a state legislator called for raising taxes on pharmacies that don't participate in Medicaid.

Now, a trade association that Walgreens belongs to has filed suit against the state, charging the state with violating state and federal laws. ACORN has gotten into the act, calling for a boycott of the company. In effect, ACORN and the politicians are calling for the state to press Walgreens into government service by dictating the terms of a contract.

So much for "negotiating" prices, eh?

You may have read that sales of Atlas Shrugged have soared lately. With Gov. Jack Markell labeling his moves as a way to impel Walgreens to sacrifice for the greater good, the book is more timely than ever in Delaware.

Delaware Strikes Back

Citing the need to stay in business, Walgreens, as I mentioned the other day, has opted out of being a provider in Delaware's Medicaid program.

It didn't take long for the state to strike back. It can't (yet) legally force the company to take its low reimbursement rates. One legislator, however, wants to punish Walgreens by revoking its right to sell to people through the insurance plans offered to state employees–which accounted for $44 million worth of business last year.

Rep. Mike Barbieri, D-Newark has said "If Walgreens doesn't want to play ball, then I think the state should look at whether we should have them as part of our contract for state employees."

The comical(?) part of the story is that making Walgreens and offer it can't refuse could end up costing Delaware some money: "The state is federally mandated to make transportation available to Medicaid patients for medical purposes. That transportation will be available to anyone who loses access to a local pharmacy when Walgreens stops accepting Medicaid."

Not Socialized Medicine Here, No Siree Bob

A friend of mine pointed me to Delaware Bill 120, a piece of legislation dealing with health care.

The first sentence of the synopsis reads:

"This Delaware Health Security Act will provide all current and future Delaware citizens, out-of-state workers employed 20 hours or more per week in Delaware and our state's economy a non-government run (NOT socialized medicine) program and cost effective single payer health care system."

To which she responds, "Really?"

The actual legislation declare "The General Assembly finds and declares that enacting a single payer, non-government run Delaware Health Security Act will guarantee comprehensive, quality health care coverage for all Delawareans from the moment of conception until one's last breath is taken." [Emphasis added]

Will guarantee? Gosh that makes me feel good. I'm glad that they can build on the success of Medicaid in making sure that everyone can see a doctor when they need to.

Walgreens to Delaware: We’re Going on Strike

Walgreens has gone John Galt on the state of Delaware by dropping out of the state's Medicaid program.

A company spokesman said "Quite simply, we can't continue to participate in a program that, in some cases, pays us less than our cost to fill these prescriptions."

The state has in turn said "we need our business partners to help share in the sacrifice that these difficult times require." One legislator suggested punishing the company. "Legally I'm not sure we can do anything to them, but if we can, I'll be looking into it," said Rep. Helene M. Keeley.

Rather than move into the "offer you can't refuse" department, the state ought to use this rebuke as an opportunity to rethink its whole approach to health care. For the rest of us, it's yet another illustration of the fact that government-paid health care is economically unsustainable.