Dempsey: The States: Laboratories of Healthcare Reform

Last week, this column discussed the importance of maintaining the delicate balance of shared responsibilities between the federal government and the states - much of it focusing on healthcare.

In response, I received reader feedback expressing concern that attempts to rein in federal spending and mandates meant keeping the status quo. I welcome these comments and believe that Missouri must be proactive in implementing real reform.

It has been said that the states are like laboratories, where solutions to social problems can be developed. I know this to be true and have benefited from the work of legislators outside of Missouri, especially as it relates to healthcare.

However, any successful plan, developed locally or in a sister state, must address several main issues. First, it must aim to expand coverage and be transparent (in order to keep quality high and costs low). But the heart of any successful program is to be found in the incentives it creates. A viable plan will encourage personal responsibility for one’s own health and provide incentives to all involved to reduce the costs associated with care.

During my time in the Legislature, I have sponsored several healthcare bills that proposed to do the following:

Senate Bill 306 (2009) – “Show-Me Health Coverage” Plan

• Partners the state and the private sector to provide health coverage to low-income Missourians for a limited amount of time with the goal of providing both a safety net for those in need and incentives to move beyond government programs
  
• Stresses preventive services (not emergency room visits) and healthier lifestyles.
  
• Makes state-sponsored programs less costly for all taxpayers by ensuring they are the payor of last resort. Other non-public sources of payment would be used first.
  

Senate Bill 149 (2009) - Seeks to establish transparency in the pricing and quality of healthcare services.

Senate Bill 415 (2009) - Removes regulatory barriers to offering flexible, fully insured Health Savings Accounts. These accounts will help dramatically lower the number of uninsured in Missouri with a unique free-market solution.

SB 1283 (2008) - “The Missouri Health Transformation Act”

• Designed to improve individual health, modernize care delivery and transform public healthcare financing to improve access and affordability.
  
• Expands an existing $2,500 tax credit to assist seniors and the disabled to modify their homes as an alternative to institutional care.
  
• Steers people who are using expensive emergency rooms for non-emergency care to primary care physicians through web-based technology.
  
• Includes Telehealth (phone-based) practitioners in efforts to modernize care delivery and expand access in rural areas.
  
• Helps the working poor gain access to affordable health insurance. Participants make contributions to a health savings account based on their income. Provides essential medical services, similar to commercial insurance plans and stresses preventive care.
  

The ideas discussed above are examples of ways Missourians can make healthcare more accessible and affordable. If you have suggestions for commonsense reforms, please do not hesitate to share them with me. I welcome your feedback.