Health Care Freedom Act on the Table in Oklahoma

The Oklahoma House Rules Committee may take up the Freedom of Choice in Health Care Act today. Then again, it may not.

A hearing by the committee would represent yet another step towards having every state legislature debate the question of whether citizens will be compelled to participate in a government health care program, or free to pay for services as they see fit.

Oklahoma Weighs Options for Medicaid Cuts

Oklahoma officials are thinking of addressing their state’s budget deficit by making reductions in SoonerCare, the state’s Medicaid program.

The story in the Tulsa World illustrates several points about government health care programs.

One, federal matching funds encourage states to be irresponsible. The feds (that is, those of us who don’t live in Oklahoma) send $3 to the state for every dollar that Oklahoma spends from its own taxes. That means when Oklahoma cuts back, it loses the federal funds, and the human damage done by the cuts is much bigger than it would otherwise be.

The second item is that if you come to depend on government programs–perhaps because laws make private insurance unaffordable–you’re at the mercy of politicians when the economy tanks. Wouldn’t it be better to have your own insurance, especially if it was in combination with a health savings account from which you could draw money? And in an environment in which a truly competitive market for health services delivered higher quality and lower prices than what we have now?

Your Right to Chose Your Treatment

Should you have an explicit constitutional right to pay for any lawful health care services you want, regardless of what a federal bureaucrat says? Oklahoma State Rep. Mike Ritze thinks so, and calls for an amendment to the Oklahoma Constitution.

The proposed constitutional amendment would

•          Prohibit any law or rule from directly or indirectly compelling any person or employer to participate in any health care system;

•          Allow any person or employer to pay directly for lawful health care services without paying any penalties or fines;

•          Permit a health care provider to provide directly purchased lawful health services without paying any penalties or fines; and

•          Stipulate that subject to reasonable and necessary rules that do not substantially limit a person’s options, the purchase or sale of private health insurance will not be prohibited.

Ritze,  a physician and surgeon, says “Many of the proposals under consideration in Congress are likely to result in reduced access to a family doctor, rationing of services, or even outright denial of care if a bureaucrat decides it is not a ‘best practice.’ My legislation would give the voters the ability to protect and preserve their existing health care coverage.”

Let Us Out of ObamaCare, Oklahoma Leader Says

Would the federal government allow states to opt out of its regulatory-heavy approach to health care? It's doubtful, but give Glenn Coffee, the Oklahoma Senate president pro tem, for floating the idea.

From the Edmund Sun:

Coffee said he will work with U.S. Sen. Tom Coburn, R-Okla., to request a waiver from the federal government to allow Oklahomans to purchase a health care plan of their choice and not be restricted to a one-size-fits-all health care regulation that is being debated on the federal level.

The Sun also notes that "There are two insurance workers for every health care worker in the U.S., he said."

Really? I'd like some confirmation on that claim. 

Oklahoma Needs to Cut Insurance Costs

The state of Oklahoma needs to save money on its insurance programs for state and local employees, says a leader of the State Employee Health Insurance Review Working Group.

"We can't keep going on like we're doing," said Rep. Lewis Moore (R-Arcadia). The, state, along with people who benefit from the employee insurance programs, spends $1 billion a year.

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.

Assertive Federalism

Federalism has too often come to mean state officials going to Washington, DC, hat in hand. But two Oklahoma state representatives have a different idea, issuing a statement decrying any actions that would federalize and politicize health care.

Rep. Mike Ritze pointed to the financial cost as one of his concerns: "Collective prepayment drives up demand because healthier citizens feel the need to 'get their money's worth' out of the system."

He also called Medicaid, one of the country's government-financed health care system, "a double-whammy: People are taxed to pay for Medicaid and then pay higher premiums because of Medicaid."

Rep. Doug Cox said "The present system requires too many clerks working in health care that are not involved in patient care. The administrative paper/computer work required is a major cost driver in the system. Unfortunately, I have not seen any part of the Obama plan that addresses this issue."

Cox should know a thing or two about medical paperwork. Like Ritze, he is a physician.

A Government Program That is Actually Temporary

The State of Oklahoma set up a hotline to handle phone calls during the swine-flu hysteria. Since the number of calls has plummeted since then, the state's going to do the sensible thing and discontinue the hotline.

Good for them.

Mandate-Lite Insurance in Oklahoma, Redux

The Oklahoma Senate has made good on an idea already passed by the House. HB2027 would allow the sale of mandate-lite health insurance policies.

There's more encouraging news from the stat, as well: "Sen. Tom Adelson, D-Tulsa, supported the measure, but said the state should do more to allow people access to health care. Adelson has proposed an amendment to the bill to allow people to purchase insurance policies from an company outside Oklahoma if the state’s insurance commissioners say the company meets requirements."

If You Don’t Like the Analysis, then Sue

When a proposed autism mandate was defeated in Oklahoma last month, a cost estimate prepared by an actuary was key in rallying opposition. Now the prime supporter of that mandate, Wayne Rohde, has filed a complaint with a national discipline board. While the actuary at the center of the complaint is not commenting on it and the discipline board asked that it be kept confidential, Rohde took his case to the press in order to rally support for the mandate.

This attempt to intimidate those who disagree with you on public policy should send a chill down the spines of policy analysts. Sometimes our work is used by legislators to make points about bills. Are we going to be hauled into court by those who disagree with us because our analyses, in the words of Rohde, "wrongfully influenced the decisions of members of the" legislature?

There is certainly room for disagreement about how much an autism mandate would raise insurance premiums. It is clear a mandate would increase these rates, but would it be 1% (the amount given in a report preferred by supporters of the Oklahoma mandate) or would it be 19% (the amount given in the report subject to the complaint)? Apparently legislators looked at these differing reports and decided that one was more credible than the other. Instead of trying to compile facts to dispute this, Rohde is now trying to intimidate those who disagree with him.

There are different ways of looking at issues. No one can quite be sure about the results certain legislation will produce. Once you open the door to professional sanctions against those with whom you disagree, what is to stop others from using the same tools against you? If, as Mr. Rohde said, the actuary should be sanctioned because "there is a lot of bias to his work" and "in no way can [his report] be right," there really is no way to avoid seeking sanctions against anyone commenting on legislation. After all, Mr. Rohde certainly has a bias. Some probably even think there is no way his views can be right. But the proper way to sort out these issues is in the marketplace of ideas, not a discipline board.

Wayne Rohde has commented on this blog in the past. If he still visits, I'd invite him to give his side of the story.