There seems to be an appetite among lawmakers for taking stock of Medicaid and where possible reducing overhead and purchasing costs while improving care.
High overhead also drives high prices in privately funded health care, but to date, the Legislature has not tackled those problems. Unlike Big Pharma, the Utah Health Insurance Association was able to fend off any probing of its vested interest in status quo health financing.
More than a half-dozen chambers of commerce supported a bill proposing a targeted study of the problems small employers have in securing employee health benefits. Virtually all of Utah's 420,000 uninsured are small-business employees or their dependents.
Ample evidence indicates that today's uninsured working families become tomorrow's Medicaid or CHIP enrollees. Those who do not qualify for government programs will be bankrupted by relatively routine illness or injury. No wonder business leaders pushed for a sensible study.
However, just as in past legislative sessions, health-insurance interests opposed any serious look at their business model. While loudly insisting that the uninsured should act more personally responsible for health care (to the point of supporting a bill that would criminalize those going without health insurance), the Utah Health Insurance Association never admits their increasingly obvious corporate failure to manage risk collectively and pay claims efficiently.
Small businesses and their employees can't manage to keep health benefits, not because they are criminally irresponsible, but because they are not allowed to purchase health benefits from a health insurer that accepts responsibility for optimizing the spread of risk among many small members, and efficiently paying claims, such as the Public Employee Health Plan.
Rather, small employers are forced to try to do business with health insurers that use actuarial games and pricing schemes to cherry-pick only the healthiest employee groups and deny claims.
Hospitals and doctors must raise prices because they are left to shift costs for the uninsured and must fight paperwork wars to be paid.
The 2007 Utah Legislature did provide one ray of hope for comprehensive health care reform. The Utah Senate unanimously passed a resolution calling on Congress to pass the Health Partnership Act this year. Though the resolution eventually died in the House Rules Committee in the last hectic days of the session, House Speaker Greg Curtis has in the recent past voiced support for the concept that Congress should allow the states to finance health care without federal interference.
The Health Partnership Act would create a national commission to negotiate comprehensive health care reform plans with willing state leaders, referring successful plans to Congress for an up or down vote in 90 days.
Perhaps next year the Utah Legislature will ask Congress to give health policy autonomy to the Beehive State so that Utahns can refuse to support the failed health-insurance business model and begin the process of building an efficient, risk-managing, health-financing system for ourselves.
What worked for Medicaid this year can work for all Utahns in the future.
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* JOSEPH Q. JARVIS is is chairman of the board of trustees of the Utah Health Policy Project.
