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Crucial conversation

How to curb health costs and deliver universal care? An Ohio House bill offers a platform for starting the debate

If there is a health care equivalent of the quest for the Holy Grail, it would be the search for a national plan that promotes a lifetime of good health and assures everyone access to affordable, comprehensive coverage and care. Every year yields a crop of proposals to reform health care at the state or national level. Yet employers, government officials and families still are burdened by high costs. And the number of residents without coverage keeps rising.

The nation's health expenses have exceeded $2 trillion a year. In Ohio, health spending is up to $89 billion annually and growing at a rate between 6 percent and 9 percent a year, according to a report last week from the Ohio Business Roundtable. An estimated 1.2 million Ohioans lack health insurance.

All of this is driving the quest for a comprehensive reform plan to improve health, reduce costs and leave no resident uncovered. Review committees appointed by Gov. Ted Strickland have been exploring options toward that end. Their recommendations are due within the next few months. Meanwhile, state Rep. Jim Raussen, the Republican chairman of the House Health Care Access and Affordability Committee, proposed House Bill 456 last week.

The legislation should serve as a valuable start to the broad conversation that Ohio must have about revamping health coverage. If a healthy population is important in itself and as an economic asset, the goal of any statewide reform plan should be to ensure universal health coverage.

Raussen's bill rightly targets a major roadblock to that goal. Health insurance companies routinely deny coverage or charge extremely high premium rates to people who develop chronic ailments or have preexisting conditions. The result is, those patients are out of luck (and usually depend on emergency care) if they don't have the good fortune to be covered by employers or a public program.

Among other provisions, the bill proposes a state-subsidized program that would enable uninsured patients with chronic illnesses to buy private coverage. The state would require insurers to cover high-risk patients, offering subsidies for annual claims between $15,000 and $50,000. Subsidies would be offered to companies with fewer than 50 employees and tax credits for poor uninsured adults who are not eligible for Medicaid to buy coverage.

The focus on the chronically ill is not misplaced. Chronic conditions account for 75 percent of health care spending, according to the advocacy group, Partnership to Fight Chronic Disease. What Ohio needs is a bold strategy that not only treats but also prevents chronic illnesses across the population. That is possible only when access to care is available to all. Raussen's bill adopts an incremental approach that will take six years to implement fully. It covers about half of Ohio's uninsured and costs an estimated $450 million to $500 million a year. Ohio has an opportunity to restructure health coverage. This bill adds to the larger discussion.

If there is a health care equivalent of the quest for the Holy Grail, it would be the search for a national plan that promotes a lifetime of good health and assures everyone access to affordable, comprehensive coverage and care. Every year yields a crop of proposals to reform health care at the state or national level. Yet employers, government officials and families still are burdened by high costs. And the number of residents without coverage keeps rising.

Get the full article here.


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