From Deseret News archives:
State health plan is under fire
Critics say it isn't a model for nation as it offers limited benefits
Gov. Jon Huntsman Jr., the Utah Department of Health and a multitude of players in health care delivery are convening for the Utah Summit on Health Insurance, "Coverage for the Uninsured."
The forum brings together a number of professionals to tackle ways to provide solutions for covering the estimated 251,400 Utahns who lack health insurance.
On the eve of the summit, however, Utah Issues — joined by other advocates — warned that the state's idea of expanding coverage should not be the blueprint other states consider in the wake of looming Medicaid cuts.
At this stage, Congress is proposing to curtail Medicaid spending by $10 billion over the next five years. Utah's share of the hit would be more than $50 million, a cut health policy analyst Judi Hilman says would shave Utah's already lean program past the bone.
"We have a real lean program already," she said, adding that such a cut will spell more exorbitant costs in the long run.
What worries Hilman and others is a program crafted under the leadership of former Gov. Mike Leavitt, who is now Secretary of Health and Human Services.
The Primary Care Network provides benefits to close to 20,000 Utahns who make too much to qualify for Medicaid but don't have insurance through employment.
Critics like PCN member Kathleen Pemberton say the program helps to an extent, but because it only offers limited benefits — with exclusions for things such as hospital stays or visits to specialists — it is not really coverage at all.
"It is like a Band-Aid for an artery that has been cut."
Consumers and advocates worry that the program, which has Leavitt's stamp on it as governor, will be the new Medicaid that emerges from painful slashes to benefits.
Those cuts could include the decimation of 60 hours worth of home health care that keeps people out of institutions, dental and vision care or transportation to doctors to get health care.
An issue statement released this week by the advocacy group Families USA warned that the PCN program, administered by Utah's health department, should not be viewed as the model for Medicaid.
"Gov. Leavitt's plan was the first of its kind — and it should most certainly be the last."
Dr. David Sundwall, the newly appointed executive director of the Department of Health, acknowledged PCN has its share of flaws and critics but said the answer lies in cooperation among all those who participate in the system.
"We count on charity care for coverage of those services for people who participate in the Primary Care Network," he said. "I fully admit for this to work, it does require hospitals, physicians and voluntary people to fill in the gaps."
E-mail: amyjoi@desnews.com
