Hospital Shoppers Get Research Tool

David Gratzer, among others, has written that it’s easier to find out about hotel rooms than hospitals.

The night before the surgery, we sat in a Hamp­ton Inn that we had selected through hotels.com. We had a rating system for the hotel. We knew the price when we walked in. We knew everything there was to know of significance about the hotel: the AM/FM radio in the room, the fact that they had an outdoor pool–not that we would be doing much swimming–and so on. And there I was in this West New York hotel mulling the dark choice that lay ahead. Here was the mundane decision I had perfect information on–the hotel–and the big decision–who was going to cut into my wife the following morning–I knew practically nothing about, nor the hospital he worked in.

Thanks to a new database in Ohio, residents of the Buckeye State now have access to more information about hospitals. The Cleveland Plain Dealer has the story.

Ohio House Votes to Raise Health Insurance Costs

Earlier this month, the Ohio House of Representatives voted to mandate insurance companies cover autism treatment and diabetes treatment. As I discuss in this Buckeye Institute article, the main result of this legislation is a hike in the price of health insurance:

Treatments for autistic children can be very expensive. Parents of these children understandably want someone else to help share their burden. Likewise, coverage for diabetics can cost a lot of money. But this legislation doesn’t really force insurance companies to pay for these treatments. Instead, legislators have forced everyone who has insurance to pay for them. Insurance companies don’t just print money to pay for services. They get money from the insurance premiums you pay. If they need more money, they raise the price of premiums….

Ohio already mandates that insurance companies must cover a number of procedures, artificially raising the cost of insurance. For instance, even if you believe that chiropractors offer few legitimate medical treatments, your insurance must cover their services. Or even if you’ve never touched a drug in your life, state legislators mandate that your insurance cover drug addiction treatment. But compared to other states, Ohio does pretty well. Legislators have been steadily adding to these mandates over the years, though, and the governor wants even more regulation of health insurance. At the same time, these same politicians decry the rising cost of health insurance, even though they are directly responsible for part of this price increase.

The bill now goes to the Senate. With Republicans in control of that chamber, it’s uncertain if these mandates will be approved.

State governments ration “free” cancer screenings

When you empower government to provide “free” health care (paid by others through taxes), government gets to decide when it’s appropriate for you to receive it.  Here’s yet another example from the Associated Press:

…low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society’s Cancer Action Network. In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears.

…

New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50….

At least 14 states cut budgets for free cancer screenings this year: Colorado, Montana, Illinois, Alabama, Minnesota, Connecticut, South Carolina, Utah, Missouri, Washington, Ohio, Massachusetts, Pennsylvania and Arkansas.

Ohio Stockpiles Flu Vaccine

From the Cleveland Plain Dealer comes the news that salvation might come from government vaults:

Should commercial supplies run short, the Ohio Department of Health has agreed to transfer doses of antiviral drugs from the state stockpile to four large retail pharmacy chains. Giant Eagle, Walgreens, Meijer and Kroger will then distribute the medications to stores where supplies are low.

I suppose it’s good to know that there are ready reserves of vaccines out there. But food is just as important for health, and we (rightly) ridicule the idea of government cheese. (In fact, “Government Cheese” is the name of a punk band!) Why government vaccines? Given the proper incentives and regulatory environment, there would be no need for people to wonder “Does my state government have enough cheese/vaccines stockpiled?”

Ohio To Destroy Access to Individual Health Insurance?

I just got back from speaking in Columbus, OH, where I learned that the state’s recently passed budget includes health “insurance” reforms that make it illegal for health insurers to price actuarial risk accurately.

As of January 1, 2010, insurers in the individual market will be forced to offer open enrolment to people with any pre-existing condition, including cancer.  Over time, the new law will force the insurer to charge the sickest new applicant no more than 1.5 times the premium of the healthiest beneficiary of the same age and gender.

This will attract only the sickest of the sick to apply for individual coverage – after they’ve already been diagnosed.  Remarkably, the bill also has the positive reform of allowing (requiring?) employers which do not offer coverage to use IRS Section 125 to permit their employees to use pre-tax dollars to buy individual policies.  It also makes COBRA continuation (for those who lose their jobs) more “generous.”

But what’s the point? If everyone can wait until they become sick to apply for individual coverage, I doubt many people will worry too much about continuing group-based coverage.

We’ve been saying that New York is an example of what the whole U.S. will look like under the looming federal health “reform.”  We may have to move our focus to Ohio, where “reform” is code for a complex mess of adverse selection, with broadly predictable, if unintended and undesired, consequences.

Ohio Speaker Practices Dubious Art of Medicaid Planning

One of the most egregious Medicaid planning attorneys is from Cleveland, OH and serves as Speaker of the House of Representatives! He is the author of the following quote:

“We have committed an act of piracy–we have broken into the Fort Knox of Government benefits and uncovered the best legal strategies available to you for claiming your share of the gold from the Government’s treasure chest…. We’ll explain how you can ’strike gold’ in the Social Security [including SSI], Medicare, and Medicaid programs…. With this book we are handing you the treasure map, deciphered from a mine of unintelligible government rules and regulations.” (Amy Budish and Armond D. Budish, Golden Opportunities: Hundreds of Money-Making, Money-Saving Gems for Anyone over Fifty, Henry Holt and Company, New York, 1992, p. xiii)

How Much Will “Reform” Cost Ohio?: Federal Medicaid expansion will burden the state

In my latest article for the Buckeye Institute, I ask how much state taxpayers can expect to pay for the Medicaid expansion contained in the health care "reform" bills moving through Congress. Some governors have orderd their budget office to estmate the burden on their state's taxpayers. Ohio's Governor Ted Strickland, a strong supporter of President Obama, has not yet done so.

Since the governor won't do it, I'll give it a shot. According to U.S. Census data, in 2007 Ohio had over 1.2 million adults living in families under 150% of FPL. Given the state's current economic woes, we can safely assume that number is larger today. Some are already on Medicaid. Some have other insurance. But many these 1.2 million would be enrolled in Medicaid under the plans being discussed in Congress.

The Kaiser Family Foundation estimates that in 2006, the average Medicaid payment on adults in the system was $2,930. Let's say that only 500,000 of those eligible sign up for the program. If spending were at the same level as 2006 (it's undoubtedly higher, but that is the last year for which numbers are available), it would mean Ohio taxpayers would be paying $586 million every year for their Medicaid. More people enrolled would, of course, increase this cost.

This number is only a rough estimate based on some very incomplete data. But it's the best we have since Governor Strickland has refused to do what other governors have done and requested his budget office take a look at potential Medicaid costs. Maybe he's afraid that having this information may make the health care legislation more unpopular. If so, that is a poor reason to deny the public this information. If we are to make a sound choice on this issue, we should know what it will cost us. Too bad the governor does not seem to feel the same way.

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.

Ohio Governor Suggests Medicaid Cuts

Ohio is facing a $2 billion deficit (even after trying to paper over its spending problems with billions in federal "stimulus" money). So it seems that Governor Ted Strickland, who came to office promising to expand Medicaid, is now looking to cut it:

Sources say the areas where Strickland has suggested cutting include: dental, vision and other Medicaid services for low-income adults; the Passport program that enables the elderly to receive care at their home instead of in a nursing home; and services to protect children and adults from abuse.

The administration also proposed eliminating preschool for low-income children, a planned expansion of tax-funded health coverage to uninsured children, and planned increases in payments to nursing homes caring for disabled.

I'm not sure the Passport cuts are all that cost-effective, since it will mean fewer people will receive less expensive in-home care and instead receive services at a more expensive institution, but in general the governor's on the right track.

Of course, if he'd listened to me two years ago, maybe the state wouldn't have quite as large a fiscal mess:

Expanding Medicaid can lead to large increases in Medicaid spending when states can least afford it — during recessions. Ohio saw this earlier this decade when Medicaid spending increased dramatically during the recent recession. Spending grew at 11 percent annually during 2001 and 2004, squeezing other budget priorities at a time when the state was seeing reduced revenue. Expanding Medicaid now will only repeat this cycle during the next recession.

Does an ‘Electronic Cigarette’ Blow Smoke in the Face of a Smoking Ban?

More and more states are banning smoking, in the name of protecting your health of their budgets. But what about a mechanical device that is roughly the size of a cigarette and delivers a mist of nicotine? Is that covered?

That's a question, among others, that the Columbus Dispatch asks in this report.