Health-care reform bills under review

One fine day, medical bills will make sense, and individuals will be able to afford insurance coverage, and patients will have as much say in their care as the doctor.

That day is quite a ways off — probably years — but initial steps toward bringing it about took form this week under three bills taken under advisement by a special legislative task force looking at reforming the state's health-care system.

The bills are basic blueprints for a reformation project that its leaders liken to building a house that is barely at the footings stage.

Complexity of the system is matched only by the cost and the number of moving parts being addressed in the reform effort, said task force co-chairman Rep. David Clark, R-Santa Clara, who will leave the post in January to become speaker of the house.

Clark reasserted his personal and political passion that the reform move ahead and that the state's longer-term goals remain viable, regardless of the point person or the whims of the economy. Health insurance will be reformed, individuals will be given and assume more personal responsibility, the medical industrial complex will be more transparent, more open to technological data sharing and inclined toward value-for-dollar demands of consumers.

One of the more immediate changes would be retooling the employer-based insurance benefit plans, not doing away with them but giving employees more options to purchase and carry coverage with them when they change jobs.

The bills, which the task force may fine tune before they're heard in committees and debated when the Legislature convenes next month, would also simplify health-care administration and communication. One change is adopting a standard coding method so procedures would have a uniform language that would simplify claims processing as well as make bills easier to understand.

Another proposal would require companies doing a specified amount of business with the state through contracts must provide health insurance to employees.

A watershed element of the legislation is allowing health maintenance organizations and preferred provider groups to be spared some state-mandated benefits. Groups have complained they haven't been able to tailor their plans to different insurance pools because they have to provide benefits that many don't need and don't want to purchase.

Another proposed change would make pre-authorization for surgical procedures a guarantee of payment for the service. Under current practice payment is a separate issue.

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E-mail: jthalman@desnews.com