Donatelli: Keep hallmarks of health care


Conservatism’s principles suggest that states, not the federal government, take the lead on reforming health care to preserve its three hallmarks: access, affordability and innovation.

To do that, conservatives from more than 30 states came up with these ideas at a meeting this month in Chicago:

Medical malpractice reform. A major cause of more expensive health care is the rash of “junk lawsuits,” i.e. suits with little legal merit, filed in hopes of securing a settlement against health care providers. A number of states, including Texas, Virginia and Oklahoma, have enacted sensible restraints on who can bring such suits and how much can be collected in damages beyond actual economic injury. Congressional Democrats have even refused to consider this sensible reform because of the handsome campaign contributions they receive from trial lawyers.

Health information. It has long been known that better use of health information technology can provide consumers with better information about their health care choices, cut costs, reduce mistakes by providers and generally enhance transparency of the entire health care system. States such as Connecticut, Minnesota and Louisiana are running successful health information exchange programs designed to improve efficiencies throughout the entire health care system.

Mandated benefits. States that require large numbers of expensive “mandated benefits” as part of all insurance policies drive up costs for everyone. Individuals and families that desire a less expensive policy with more limited coverage should have that option. Florida and Georgia are among the states that have tried to bring enhanced choices for patients and families by eliminating state mandates that drive up costs. Unfortunately, President Obama wants to go in precisely the opposite direction by requiring that every new policy written contain an unspecified package of benefits regardless of the wishes of the individual purchaser. Enhanced purchasing options. Wisconsin Republicans are preparing a bill to establish “regional pools” to allow individuals, small businesses and civic organizations to purchase insurance policies in other participating states. Currently, insurance is regulated on a state-by-state basis, but such regional pooling would allow more choices and bargaining power to families, small businesses and civic organizations in their negotiations with insurers.

Medicaid reform. Obamacare proposes to spend an additional $440 billion over the next 10 years on a huge expansion of Medicaid, the federal-state program that offers medical assistance to poor Americans. Mississippi, Indiana and Alabama and other states are improving the efficiency of the program to better target aid to the most needy recipients. States are also tackling the problem of program fraud, which continues to be a serious concern with the delivery of Medicaid services. This is a far better course than for Washington to pile additional unfunded obligations onto state budgets that are already under serious stress.

To be sure, some important health care reform issues require action at the federal level. Two favored by most Republicans would be to equalize the tax treatment for individuals who purchase their own insurance and those who obtain insurance through their employers, and to expand and promote health savings accounts, which allow families to save money tax-free in a special account to pay directly for medical services.

There are problems in America that require direct action by the federal government. By contrast, major reforms in health care can be enacted at the state level. Conservatives are developing such practical, common-sense solutions. As we watch Obamacare implode, conservatives are already taking these state reforms directly to the American people.