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Health care reform

The new federal health care law will exacerbate many of the problems it was meant to address.

Some of the most effective health care reforms are changes in state policy, most of which are still available. Such reforms would only mitigate the costs to North Carolinians of federal law instead of resulting in a net reduction of health care costs, but they are still needed.

Key Facts

• The federal tax code punishes those who do not get insurance through their employer.
• Governments and insurance companies pay $7 out of every $8 spent on health care.
• Costs have risen as patients have paid a smaller portion of their medical expenses.
• Medicare accounts for half of the growth in medical costs.
• New treatment methods, pharmaceuticals, and diagnostic tools are often more cost effective than older methods when adjusted for inflation and health improvements.
• The federal health insurance law will add 15 million people to Medicaid across the country, 500,000 in North Carolina alone.
• Companies will need to file tax forms for any purchase of any good or service over $600 starting in 2011.
• President Obama acknowledges that insurance premiums will rise 10-13 percent on average by 2016, and 17 percent for young healthy individuals, but nevertheless the president claims that the new policies will be better.

Recommendations

1. Focus on care, not coverage. Reform should expand access to quality care to more people throughout the state. Enrolling more people in Medicaid does not accomplish this goal.
2. Give state employees control over their own health. Provide a policy option for state employees to set aside money in a tax-free account to pay their medical expenses. If done with long-term accounts, this would also reduce the state's $29 billion unfunded liability for future retiree health benefits.
3. Let free enterprise flourish. State restrictions on health insurance, care provision, and capital investment mean patients have fewer options for obtaining excellent care at reasonable costs. Some changes the state could take to offset the cost-raising and access-reducing aspects of national health care reform:
• Allow individuals and businesses to purchase insurance from other states
• Reduce mandated benefits for insurance companies
• Ease restrictive licensing burdens on medical professionals
• Repeal Certificate of Need
4. Reform medical malpractice. This means not just putting caps on punitive lawsuit awards, but allowing doctors and patients to agree in writing on the costs of malpractice. Too many injured patients never even file suit.