Medical-Tort Law: Ranking the States

How much do a state’s laws governing medical malpractice and other torts relevant to health care affect the availability of care?  Plenty!

Lawrence J. McQuillan’s & Hovannes Abramyan’s 2010 edition of the U.S. Tort Liability Index, which has a number of measurements included in the U.S. Index of Health Ownership, ranks states according to 42 variables.

Eight of the measurements in the U.S. Tort Liability Index are relevant to the U.S Index of Health Ownership: One output and seven inputs. The previous edition of the U.S Index of Health Ownership included six measurements of medical tort, but McQuillan & Abramyan have discovered more variables for their 2010 edition of the Tort Liability Index, allowing more detailed measurement.

As a partial update of the U.S. Index of Health Ownership, this brief analysis calculates a medical-tort index from a simple average of the eight relevant variables.  Mississippi, Nevada, Michigan, Colorado, and Louisiana lead the pack; while Vermont, Rhode Island, Kentucky, Pennsylvania, and Iowa bring up the rear. Even the leaders, however, lag in some measurements.

Mississippi, for example, leads on procedural rules: Pre-trial screening or arbitration and conditions on the use of expert witnesses. However, it does not limit lawyers’ ability to abuse their privilege by limiting their share of awards. Colorado and Louisiana also fail to impose limits. Unfortunately, the laggards do not show a similar pattern: The bottom five states perform poorly in all eight measurements.

Reducing the burden of medical tort is critical to increasing Americans’ health ownership and reducing medical costs that curtail our access to care. Some progress is evident, but states aiming to improve their medical-tort laws still have a long way to go.

Dirigo, Praised as Inspiration for ObamaCare, Costs $10.4k per Uninsured Annually

This past weekend, former Virginia governor and current Democratic National Committee chairman Tom Kaine “praised Maine’s health care plan, Dirigo Health, as an inspiration for federal reform.”

Interestingly, just two days before, the Dirigo Health Agency revealed their latest spending and enrollment numbers (PDF).  As of April 2010, just 7,584 were enrolled in DirigoChoice.  Only 36% on DirigoChoice are actually previously uninsured,  according to the State’s own estimates (PDF).  That means that as of April 2010, Dirigo covers just 2,730 uninsured in Maine.

How much did it cost taxpayers to cover 2,730 uninsured?

Again, Dirigo Health Agency’s own report (PDF) gives us the answer.  Dirigo is costing Maine taxpayers an estimated $10,408 per uninsured Mainer actually covered per year ($312.23 per member per month average subsidy /36% actually uninsured) x 12 months).  In total, Dirigo has cost Maine taxpayers $26.3 million for the first ten months of FY2010 alone.

Oh, and it is $1 million over budget so far this year, despite declining enrollment.

I have to agree with the Democrats.  It does seem like Dirigo was the inspiration for ObamaCare.

ObamaCare Mandates up to 60,000 Person Maine Medicaid Expansion

Today, the Kaiser Family Foundation released a report estimating that ObamaCare will force a 43,500 to 59,500 person Medicaid expansion in Maine.  This is on top of the current 290,779 people already on Maine Medicaid (about 22% of the population).

The Kaiser report estimates that this expansion will cost the State of Maine nothing, as supposedly the federal government will pay the total bill.

On a related note, the total federal debt just passed $13 trillion(13,000,000,000,000), or $118,000 per taxpayer.

It’s no wonder 47% of Mainers are opposed to ObamaC

Implementing ObamaCare in Maine

State governments now have the job, foisted on them by Congress, of figuring out how to make semi-nationalized health care work. The Maine Heritage Policy Center observed a committee meeting of Maine’s “health-industrial complex” that gathered to discuss ObamaCare, and provides a live blog on the event. It’s a cynical yet darkly enjoyable read.

If you think ObamaCare is the end of the road, think again. Steve Bowen, writing for the center, says that the legislature gave the committee the charge of figuring out “how federal legislation affects the ability of the State to adopt a system of universal health care through a single-payer plan or other mechanism,” and a single-payer advocate from the Legislature is sure to ask questions.

Bowen also asks a good question about the place of state governments in our political system. A representative from the National Council of State Legislatures [[NCSL] gave a presentation on the law, prompting him to ask, “When did the states – whose legislatures are represented in Washington my Wilson’s NCSL – decide that they would simply surrender to the feds and allow their reserved powers under the constitution to be completely trampled by the U.S. government?” Some individual legislators made their voices of opposition known, but not enough, apparently.

Health Savings Accounts in Maine up 144% in Just 2 Years

According to a report released yesterday, 10 million Americans have Health Savings Accounts (HSAs)!

These lower premium, higher deductible private health insurance plans allow individuals to pay lower premiums in exchange for a larger up front deductible – on average a deductible of $2,300 for an individual and $4,400 for a family (small employer plans), according to the report from America’s Health Insurance Plans.

In Maine, HSAs are extremely popular.  In 2008, there were 18,211 Mainers with HSAs or 2.2% of the market, according to AHIP’s report that year.  In 2010, that number had climbed to 44,499, up 26,300 or 144% in just two years.

It’s no wonder.  HSA plans are much cheaper.  According to Kaiser’s Annual Health Benefits Survey 2009, an HSA plan costs $319 a month for an individual and $866 a month for a family.  Traditional insurance plans cost $409 a month for individuals and $1,133 for families.  That means that an HSA plan annually saves individuals $1,080 and $3,204 in lower premiums, compared to traditional plans.

To learn more about HSAs and how they might be right for you, view my presentation on the subject or talk with a health insurance broker.

Price Shop When Using Health Care

Yesterday’s  Maine Sunday Telegram has a story by John Richardson about the wide price differences charged at various providers for the same health care procedure.  The story includes a great graphic showing price variations for Anthem customers compared to the uninsured for some common procedures.

The article tells the story of a particular customer with a high-deductible plan who regrets not price shopping, or using Anthem’s own price comparison tool, to save money.  Sadly, the patient blames Anthem rather than taking personal responsibility for being a more prudent consumer.  After all, she is paying the bill for the first $5,000 in care – not Anthem.

We all drive a few miles to buy gas that is a couple pennies less per gallon.  Maybe we should consider doing the same when it comes to procedures that cost thousands of dollars.

Of course, if you want to see even more dramatic price differences, compare hospitals within all of New England.  Several large employers in Maine are using the services of third party administrators such as Patient Advocates LLC of Gray, Maine to save even more money by letting their employees choose to go to lower-cost and higher-or-equal-quality hospitals out of state.  Think of it as medical tourism without leaving New England.

Surprise: ObamaCare will Cost More than Estimated

The Washington Post reports that the 10-year cost of ObamaCare could be $115 billion more than originally estimated (that’s about the price of Greece).  That is if Congress spends the total needed to actually implement the law.  In March, before the the final vote in Congress, the Congressional Budget Office had estimated the 10-year cost at a much more reasonable $938 billion.  Let’s see… in two months, ObamaCare’s cost estimate increases 12%.  And, of course, ObamaCare has yet to even begin.

On the positive side for Maine:  ObamaCare makes Dirigo Health’s cost-overruns look minor.

We Will Not Be Duped

This Thursday, April 1, President Obama will be at the Portland Expo in Portland to try to convince Maine people his health care takeover is good for America. We know better, and we will gather en masse to show him we will not be silenced, and we will not be duped.

The Maine Heritage Policy Center and other taxpayer rights groups will be gathering outside the Portland Expo (239 Park Ave., Portland) beginning at 12:30 in the afternoon on Thursday to make sure the press, the public, and most importantly, the president hear our message. Maine people are fed up with the takeover of private industry, our massive federal debt, and the largest expansion of government since the New Deal.

The president is coming to Maine to tout his health care takeover and to give a pat on the back to First District Congresswoman Chellie Pingree for championing his and Nancy Pelosi’s far left agenda. But make no mistake; he’s coming here for other reasons as well.

Since Day 1, Maine has been at the center of opposition to his takeover of health care. Our state’s disastrous experience with government-run health care, Dirigo Health, has been reported by the New York Times, the Boston Herald, the Washington Post, and even Fox News’ Sean Hannity Show. The president is worried that Maine peoples’ opposition to his historic expansion of government will carry through the November elections. That’s why Congresswoman Pingree is displaying him around town.

He’s also coming to Maine to put pressure on Senators Olympia Snowe and Susan Collins–two steadfast opponents of his government takeover of health care. The president wants to pressure them both to support his agenda of government expansion.

Expanding DirigoChoice to the Whole Country

The vote cast last night was a vote to drastically expand the control the federal government has over the lives of hard-working American families. Make no mistake; the president’s overhaul will raise taxes, raise premiums, eliminate jobs, and raise our national debt to unprecedented levels. Worst of all, the president’s plan will have politicians playing doctor, and authorize them to delay or deny health care to millions of Americans.”

We know how this movie ends. Maine’s own big government health care debacle, DirigoChoice, has been a colossal failure. We now have more uninsured today than before Dirigo was passed, and premiums for that plan have spiked 88 percent in just five years. And while Dirigo covers just 7,900 people, the program has cost taxpayers more than $160 million. The House vote last night amounts to the enactment of DirigoChoice for the entire country.

We are extremely disappointed in Representatives Chellie Pingree and Mike Michaud for disregarding the overwhelming message thousands of Mainers have sent this past year though letters, phone calls, e-mails, petitions and rallies. The votes our representatives cast reveal their allegiance to Barack Obama and Nancy Pelosi’s far left agenda of government control, and it comes at the expense of Maine people. The people of Maine are ashamed of their representation in the United States House of Representatives.

Last night’s vote was an assault on the fundamental American values of freedom, individualism and limited government, but this fight isn’t over. The unprecedented level of activism and engagement among Americans to oppose the president’s health care takeover will carry through to the November elections and beyond. We will not be silenced. We will continue to fight to protect Maine families from an intrusive, unaccountable, and now, great expanded federal government.

Lessons from Maine

The Connecticut General Assembly  is considering SB194, which would change the process by which insurance companies obtain rate increases in the individual insurance market.  I offered some perspective before the Insurance and Real Estate committee, drawing on our experience in Maine.