Friday, February 15, 2008

Oklahoma's Terrible Health Care Legislation Obviously Influenced by Lobbyists

You may hear some ranting liberal go on about health insurance company lobbyists being the scumsucking scourge of the legislative process in America, but sometimes it's hard to pinpoint the end result of all the influence peddling. However a new bill passed by the Oklahoma House of Representatives erases any doubt as to the end result of all that congressional backscratching.

Health insurance companies don't really cover all health care needs. The insurance companies are always trying to get out of covering people for certain tests or procedures regardless of the benefit received from those tests and procedures (even if they can save lives) because they can get rather expensive. Health insurance companies aren't interested in health; they're interested in making money. In order to coax health insurance companies into covering the tests and procedures that they should be covering anyways, the state legislature has created mandates in the past to force any insurance company wanting to do business in the State of Oklahoma into covering certain procedures. The legislature's list of 14 mandates includes coverage for prostate exams, mammograms and treatments for diabetes and certain types of mental illness. The state had to create these blanket mandates because it is impossible for an individual to negotiate medical coverage a la carte, and insurance is worthless if it doesn't cover whatever your particular ailment happens to be.

House Bill 3111 solves a problem that never existed. The bill requires that any future mandate legislation be accompanied by a cost-benefit analysis to be paid for not by the state legislature but by the organization requesting the additional coverage. But the really pernicious clause of the bill calls for a limit on lawmakers introducing and passing a bill mandating coverage unless the bill is introduced in an odd-numbered year and then may be acted upon by legislatures in an even-numbered year. There are a couple of ways of looking at the effects of this proposed bill. It could kill half of the proposed mandate legislation, legislation that only exists because the government cannot rely on private insurance (or the free market in general) to look out for what's best for the people of the state, since the amount of time that a bill can be introduced is slashed in half. Or it could simply create a couple of extra unnecessary bureaucratic steps; a couple more hoops to jump through before anybody could be screened for ovarian cancer, for example. It doesn't eliminate the legislature's ability to pin a mandate on the tail of the insurance companies, it just blindfolds the legislature and spins it around a few times. One thing is for certain though; the insurance companies will save a lot of money while the mandate tightrope walk is slowing down legislative efforts. And you must be a Republican or a lobbyist to believe those savings will be passed down to you the consumer.

House Bill 3111 was passed by the Republican controlled House 53 to 46, with no Democrats voting in favor, and two Republicans (one of whom is the only medical doctor in the House) voting against. There are some good quotes from pissed-off Democrats in the state House in this article, such as the one from Scott Inman, D-Del City: "What this bill was all about was the insurance industry saying we want more time to be able to kill any mandate bill that comes down the pike." Or these from Ryan Kiesel, D-Seminole: "It is repugnant that an insurance company that takes your dollars won't cover an exam that can save your life.... We're not asking insurance companies to do something that's out of the ordinary. We're asking them to do something that they should be doing already."

Two more quick points:

1. This bill is a perfect example of the process by which individual rights and freedoms are taken away by those in power. Curtailing freedom is never done in one fell swoop; it's always a long road that starts out with limits, then restrictions, then obstacles, then narrowly viewed readings, until finally whatever right was there is effectively gone and nobody notices that they don't have it anymore. Now, medical insurance may not be a right like free speech or not having your stuff illegally searched and siezed, but the process is the same.

2. The talk of the nation shouldn't be about "Universal Coverage" or "Covering the Uninsured" because insurance doesn't take care of you, doctors and nurses and hospitals do. Getting sick isn't something that can be planned, and it isn't limited to certain people, and it isn't cheap. That's why if our government exists to protect and serve the people over which it rules, and if it believes that a healthy population is in the interest of the state, the government should be the entity that dispenses the health care, not the health insurance.


Jacob said...

The tests and procedures you gave as examples (in the mandate, I guess) all seemed to relatively inexpensive, though. Do you know why insurances companies fight these in particular (as opposed to more costly procedures)? And are all of them along the lines of preventative care? Don't those usually save whoever's paying the bill more in the long run? Why wouldn't insurance companies be in favor of these? Is the number of additional people who would get the future proposed screenings (but don't currently get them) so high that added together they cost more than the catastrophic intervention required when no screening is performed (always stressed to be as the most expensive part of health coverage).

Steve said...

The mandates that are existing wouldn't be threatened by this legislation, as I understand it, so the insurance companies would be fighting against future coverage mandates that may include lifelong illnesses. They probably already don't like the idea of paying for patients with the incurable inflictions of diabetes and mental illnesses.

As for not wanting to cover screening tests for some diseases, preventative care may not actually be in the best interest of the insurer. On average people change insurers every 5 years because they change jobs or because the employers themselves change health plans when one company raises rates more than others (that study may have been one I linked to on the sidebar, I don't remember). So the insurers don't want to get stuck paying for someone's long-term illness in the short term if that person isn't even going to be with the same insurance company in the long term.

Jacob said...

I totally hadn't considered the frequency of insurer changes. Makes total sense. Thanks, Steve.