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Column For Week of: February 14, 2011
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With Federal Health Care Struck
Down, It’s Time for True Reform
Now that the national health care bill has been struck down by the
courts, state lawmakers can focus on true reform that will bring down
health costs for everyone. If costs fall, insurance premiums will follow. I
strongly believe employers could use their savings to put Missourians
back to work. Market reforms will help put our economy back on track
and now is the time to do it.
Therefore, I have offered a package of health care bills, with each bill
designed to foster competition in the health care market in a particular
fashion. Where competition exists, prices fall and quality improves, too.
Allowing competition to operate in the health care marketplace would be
great for employees, great for employers, and great for our state as a
whole. This package of health care legislation is my top priority.
The single most important step is to achieve “transparency.” While
it’s a buzzword for pundits, transparency enables consumers to make
informed decisions. Put another way, it means that you as a patient
should be able to know how much a procedure or service would cost at
different providers in your area — this way you could save money by
being able to choose the lower cost option if you want. As it stands now,
patients only find out the cost of a procedure or service when the bill
arrives. Under my plan, Senate Bill 153, your insurance company would
provide an estimate for you in advance of how much your out-of-pocket
cost would be at various providers. The estimate would take into account
the amount already paid toward your deductible during the year, and
since the insurance company knows the allowed amounts for each
provider as well, the estimate could be very accurate. When transparency
has been implemented into other markets, such as books (Amazon.com),
life insurance, and travel (Travelocity.com), prices have dramatically
Uniform health insurance applications could help, too. When
employers ask for bids to insure their employees, each insurance
company has its own application form that every worker must complete.
Often, brokers only get two or three bids, because of the time it takes to
complete all those applications. If every company used the same form, a
broker could get many bids, increasing the number of competitors an
employer can choose from. Senate Bill 92 would enable this to happen.
Sometimes insurance companies ask hospitals and other providers to
agree not to contract with any other insurance company for a lower
payment rate. The idea is to lock competition out of the marketplace, and
where this has happened, insurance costs have stayed high. Senate Bill
98 would increase competition by outlawing such contract provisions,
which are nicknamed “Most Favored Nations Clauses.”
Senate Bill 111 would prohibit health plans from stifling competition
when they refuse to negotiate with providers who are willing to accept an
insurance carrier’s base fee schedule. Some physicians are even willing to
accept less than the standard fee schedule to participate in the insurance
company’s network, in hopes of keeping patients that they’ve been
treating for years. When carriers refuse to negotiate lower rates for
patients and employers, it keeps the rates high and thwarts competition.
This bill can make a tremendous impact on health care costs in our state
because it would help bring down insurance premiums, but still preserve
your ability to see your own doctor.
Insurance is designed to save you money, not cost you more.
However, a pharmacy will sometimes charge a co-pay of $10 or more for
a prescription drug that usually costs much less! Senate Bill 122 would
prohibit this practice, saving claims paperwork, lowering the cost of care,
and stopping this injustice.
When hospitals refuse to allow medical staff privileges to physicians
who also have privileges at a competing hospital, market competition is
decreased. Taking competitors out of the marketplace eventually causes
costs to go up. Senate Bill 136 would stop this kind of “economic
credentialing” by hospitals. Another bill, Senate Bill 214, would give
doctors the right to continue competing locally by protecting them from
restrictive covenants in their employment contracts. Such clauses are
also called “covenants not to compete” — but to bring down costs, we
need doctors to compete!
Finally, imagine your health insurance company dragging its feet for
months to do the paperwork needed to add a provider, perhaps your
favorite doctor, to its health network. In the meantime, you are forced to
see another doctor instead. This is one more practice that prevents
competition in the market place. Senate Bill 215 would force them to
speed up the process.
These eight bills all increase competition in the medical marketplace.
If any or all of them pass, the health care market will operate more
smoothly and with more competition. Another bill I strongly support is
Senate Bill 86, sponsored by Sen. Jim Lembke. It would repeal the
Certificate of Need (CON) Law that prevents the construction of new
medical facilities that cost more than $1 million, unless government
permission is received first. The CON process has prevented the
construction of buildings costing more than $1.2 billion in Missouri, in
which many construction companies have given up on Missouri and
decided to build across the state line in Kansas (where no CON law
exists). CON is an example of “central planning,” which is the main
feature of socialism, or the opposite of free market competition. CON
should be eliminated.
It is my pleasure to serve the state of Missouri and those in the 34th
District. I will continue to fight for the well-being of your health and
finances, and when the improvements are made in the health care
industry, we will see a prosperous economy in return.
If you have any questions or comments concerning this matter or
any other issues within state government, please feel welcome to visit
my website at www.senate.mo.gov/schaaf. You can also e-mail me
or call my district office at (816) 233-0300.
Capitol Office Website: Phone Number:
State Capitol www.senate.mo.gov/schaaf (573) 751-2183
Jefferson City, MO 65101