Utah's health-care system isn't seriously ailing but has a few costly aches and pains that need treatment, according to a report on its way to the governor.
The lengthy study, officially adopted Wednesday by the Governor's Task Force on Health Care Costs, concludes that most Utahns - with the exception of those with low income - feel comfortable with the existing health-care system in terms of quality and accessibility.But while there's comfort, there's also widespread concern that health care costs too much, health insurance is difficult to obtain, and there's an apparent lack of competition and anti-competitive practices in the health-care market.
These and other findings, and recommendations for dealing with the problems, will be presented to Gov. Norm Bangerter Sept. 27 by the 14-member task force.
The group, composed of industry representatives, legislators, members of public-interest groups and interested citizens, has examined the impact of the open-market policy on health-care costs, quality and accessibility since April 1987.
"We identified what is happening but weren't in a position to determine why," members concluded Wednesday.
Through various data, task force members learned that total health-care expenditures in Utah rose at a higher average annual rate from 1982 to '86 than in the previous six years when the Certificate of Need law regulated health-care expansion. Hospitals have been, and continue to be, the most significant factor in rising health-care costs. Their expenditures comprise about 46 percent of total Utah health-care expenditures.
According to the report, rates of increase in Utah hospital expenditures have been higher than regional and national averages since 1976. And since the elimination of regulatory controls at the end of 1984, they have increased at an even faster rate.
While this suggests that open-market mechanisms aren't working effectively, the task force isn't recommending that the laborious Certificate of Need procedure be resumed.
Instead, they're recommending that the Utah Department of Health regularly review levels and causes of hospital costs, and the state work toward facilitating market mechanisms to encourage competition on the basis of price and quality.
Numerous other findings and recommendations are included in the report. These are a few of them:
Finding: The shortage of certain types of health-care professionals _ most importantly, nurses _ has extraordinary implications for the future control of health-care costs.
Recommendation: Efforts should be taken to increase the supply of nurses by increased state support of nursing schools.
Finding: Access to health care is a problem for those without insurance or those who are underinsured.
Recommendation: Efforts currently being undertaken by other task forces, state agencies, committees and private foundations to expand health insurance availability to uninsured individuals and groups should continue. Their proposals should be given consideration when presented.
Finding: Physician and health facility liability expenditures are major factors in the increase in health-care costs.
Recommendation: The Legislature should consider appropriate remedies for this important problem.
Finding: Many ethical issues contribute to the costs of medical care.
Recommendation: This is a subject for a future task force to consider. Issues needing to be addressed include the prolonging of life by mechanical means, organ transplantation eligibility criteria, and the use of palliative "halfway" technologies.
Finding: There's apparent market dominance in certain sectors of the health-care industry, which has created concern about the potential for anti-competitive behavior that could be detrimental to Utah health-care consumers.
Recommendation: The attorney general should investigate, and the governor and Legislature should be sensitive to the problem.
Task force members said they didn't have time to declare the "market approach" either a success or failure.
"Although there is inadequate evidence to pass judgment on the market-oriented health care cost-containment strategy in Utah, the task force believes that neither a strictly `hands-off' stance nor a completely regulatory policy can effectively balance cost, quality, and access concerns," the report says. "Rather, a combination of market forces and enlightened state intervention is required, and adjustments in the balance between these may be required."