Transparency Hot, Mandates Not
State efforts to expand health care reforms were on the rise in 2007, but recent budget predictions have slowed the trend considerably. While some states are making moves to improve quality, affordability, and access, others have adopted policies in transparency, requiring institutions and hospitals to disclose errors.
Negative fiscal impacts are already being felt in 2008 by 18 states making reforms, but industry analysts claim that most of the same reforms that took place last year will be debated again this year.
Transparency measures are a hot topic in Texas where successful bills were passed requiring that patients receive timely cost estimates from doctors, hospitals, and coverage plans. Doctors claim that these measures put administrative strain on their practices, and that it takes too much time to steer patients through their policies. Most of this problem is due to the absence of clarity in most health plans regarding what is covered, co-payments, in-network physicians, and deductibles.
Other measures such as disclosing anticipated charges to patients will require more effort from physicians, but Dr. Susan Strate of the Texas Medical Association says that transparency will create more stability in the whole system. However, insurance mandates as those seen in Massachusetts have been a harder sell in other states.
A mandate would require those who didn’t have insurance to purchase it, or for employers to supply funds for its cost. About 12 states debated this type of legislation but none of them adopted it, citing financial and political barricades.
In Virginia a mandate on businesses was shot down quickly. Industry members there said that it would place the state at a disadvantage when competing for big businesses to move their operations there. Other state reforms in 2007 initiated consumer subsidies for purchasing private coverage and incentives for those joining wellness programs.
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