Health-care reform best left to states, Utah House speaker says

The best way for the federal government to help Utah reform its health-care system is not to help, at least not right away, two Utahns leading the state's reform effort told a U.S. Senate committee Tuesday in Washington, D.C.

Rep. David Clark, Utah House speaker and co-chairman of the Legislature's reform task force, said the federal government should not be rushing to reform health care for reform's sake but instead support states such as Utah that have aggressively taken on health care.

The federal government could do best by granting states' reasonable requests to waive some federal health-care mandates as state-based reforms that address cost, waste and access to care are planned and implemented.

"The best way for the federal government to be involved is to respect individual states and keep in mind how far along in the reform process each state is," Clark said. His brief comments included a plug for allowing market-based solutions to be implemented before imposing a federal reform plan.

"We feel confident that the invisible hand of the marketplace, rather than the heavy hand of government, is the most effective means whereby reform may take place," Clark's written testimony states. "The state must be involved in shaping reform, but the government's role should be limited to simply facilitating the necessary changes."

He noted, as several national news organizations have pointed out, that Utah has the lowest health-care costs and best health-procedure outcomes in the country.

Clark, who believes reform will require both state and federal government collaboration, was joined by fellow Utahn Dr. Brent James, an administrator with Intermountain Healthcare and an internationally recognized authority on medical care cost containment.

Costs in health care are anything but contained, James told senators, saying half of the $2.4 trillion spent each year in the United States is wasted. "So there's a huge opportunity there," he said.

To this end, doctors must have access to the latest research that compares the clinical and cost effectiveness of different types of treatments and utilizing the system. That will help doctors and patients choose the best treatment and make more informed choices rather than waste money on less-effective treatments. The committee is gathering information from several sources as Congress and President Barack Obama gear up to do something about the relentless strain health care puts on the national economy.

Several states, like Utah, are moving ahead of the federal changes, in part because they are worried the fixes that are needed aren't going to be possible under draft plans being aired so far, which range from a Medicare for all to a "public option" plan for those who don't like their insurance plan at work or any private health care coverage option.

Representatives from Massachusetts and Vermont, invited to give committee testimony regarding their reform efforts, said neither the state nor the country can afford the health-care system the U.S. has, and unless costs start to level off, no reform will work, whether it's state-built or a federally imposed universal system.

E-mail: jthalman@desnews.com