A set of three bills designed to ultimately replace the wildly expensive and unaccountable "sick care" approach to medicine with an actual "health-care" system of illness prevention and personal accountability, was approved unanimously by a House review committee this morning.
The first, HB188, codifies the notion that normally healthy people should normally be healthy, and that overeating, lounging or smoking their way into obesity, diabetes heart ailments and other so-called diseases, which are not diseases but chronic conditions of lifestyle for most, is a key component in the ailing and failing U.S. health-care system.
HB188, which addresses the insurance industry specifically, amounts to a basic paradigm shift in Utah's health care system for insurers and the insured with a carrot-and-stick approach: Along with offering a basic medical insurance plan for the first time, workers will able to carry coverage from job-to-job instead of drop coverage due to the cost of premiums, and it in effect forces them to stop eating themselves sick and start exercising.
The bill, which has been two years in the works, is the starter motor for a new health-care vehicle, which sponsor, House Speaker Dave Clark, R-Santa Clara, who co-chaired a health care reform task force, believes will likely take a full 10 years to design and implement.
Just the bill's highlights of proposed changes, which go on for 46 lines, are a combined strategy of several repairs and new options for medical insurance. It includes a mandate on the insurance industry to cater to the small business market, which is increasingly opting out of insurance coverage for their employees.
A low-cost health benefit plan called the Utah NetCare Plan is to be offered by 2012 as an alternative to current laws that allows an employee who leaves a company to continue to be covered under the company's plan, known commonly as COBRA.
Ron Pollack, head of the health care policy think-tank Families USA, said that COBRA is one of biggest problems with current health care, since many unemployed people can barely cover living expenses. While the intent is to keep people insured between jobs, the fact that they have to carry the burden of almost the whole premium makes that difficult.
"A lapse in coverage between jobs is almost a certainty," he said.
A big change for the insurance industry is a requirement in the bill that brokers disclose their commission and compensation prior to selling a health benefit, just as real estate brokers disclose the amount of their commission for selling someone's house. HB188 also builds in similar so-called "transparency" regarding the plans benefits, provider networks, wellness programs, claim payment practices, and financial solvency ratings, plus establishes a process for a consumer to compare health plan features on the Internet. Ideally, this will help them comparison-shop for health insurance in the same way they currently shop for televisions or cars.
HB165, the second bill approved in committee Friday, addresses specifically the administrative side of the system by proposing several ways to streamline processing of billing and tracking medical procedures. It also brings patient information and medical service provider data bases up to date with information technology that is common in other industries. The sponsor, Rep. Merlynn Newbold, R-South Jordan, said that in an era of instant information access and sharing, medical care is lagging way behind and as a result is inducing waste in the processing of medical services — not to mention serious errors in care — sometimes just through poor penmanship and communication.
HB331 makes providing health insurance a requirement for any company doing contract work for the state and establishes enforcement and penalties for a contractor who doesn't. The sponsor, Rep. James Dunnigan, R-Taylorsville, said the proposal "evens the playing field" for all businesses contracting with the state so that those who don't provide insurance no longer have a financial advantage in the bidding process because they can do a job cheaper than companies that provide health insurance.