State Republicans Fret Over Health Insurance Companies

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Two recent public announcements here illustrate the state GOP’s health-care philosophy, which is to protect the profits of insurance companies at whatever cost to patients.

First, it was announced that Republican Gov. Mary Fallin, at the request of Republican Oklahoma Insurance Commissioner John Doak, signed a new rule that eliminates birth as a qualifying event for health insurance, which means some parents could conceivably be faced with huge hospital costs if their newborn baby has severe medical problems. The reason given for the rule is that it would encourage more insurance companies to offer policies in Oklahoma. This, so goes the doublespeak, could actually mean more children overall would be covered. Thus, some children won’t be covered so other children will be covered only to ensure insurance companies’ profits.

Second, the federal government announced on Wednesday it has rejected Oklahoma’s request to exempt the state from a federal rule, the Medical Loss Ratio, under the Affordable Care Act. It requires some insurance companies to apply 80 cents of every dollar they earn on actual health care or pay rebates to customers. According to media reports, Doak wanted the rule to be implemented gradually through the next few years to prevent what he sees as a disruption of the market, or, in other words, to make it a financially easier for insurance companies. The Feds said no.

Here’s Fallin’s telling take on the recent issue, according to the Tulsa World:

The (Medical Loss Ratio) requirements in the law are particularly harmful to private insurers and may ultimately raise insurance costs for consumers, reduce access to care and destroy private-sector jobs.

I am frustrated that President Obama continues to reject efforts by states to lessen the impact of harmful and burdensome federal regulations, and I remain hopeful that the president's health-care plan can either be repealed or struck down on the federal level.

Note the “harmful to private insurers” remark comes first before she mentions “consumers.” What about patients? What about Oklahomans who pay exorbitant amounts of money for lousy insurance coverage so companies can earn more profits? Does Fallin care about them? Does she really believe her party’s free-market-at-any-cost philosophy about medical care will result in a better system? It hasn’t so far. The U.S. ranks extremely low in medical outcomes and highest in costs when compared to other industrialized countries. Oklahoma, in particular, has poor medical outcomes.

In a direct challenge, the U.S. Department of Health and Human Services argued the new rule lowers health insurance costs for people and that has already been proven true in states where companies have adopted the 80-20 rule.

There’s not much Fallin and the GOP can do about the Affordable Care Act but hope the U.S. Supreme Court rules it unconstitutional or that the country elects a Republican president in November and also elects GOP majorities in both the House and Senate. Meanwhile, Oklahoma officials should abide by the new rules. The old rules didn’t work. Give the new rules a chance. Let’s see what happens.

Fallin’s Choice

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Whatever people might think about the specific decision by state officials to remove birth as a qualifying event for health insurance, it should serve as a reminder that our medical system remains relentlessly ruthless.

Gov. Mary Fallin, according to a media report, recently signed the rule as requested by the office of State Insurance Commissioner John Doak. Fallin’s office said the reason was to entice health insurance companies who offer policies for children to come back to do business in Oklahoma. The companies stopped offering child policies in Oklahoma because of the “president’s health plan,” according to Fallin’s office.

Fallin spokesperson Alex Wentz was quoted this way about the issue: “We think it will get more kids covered. It's not perfect, but honestly, we view it as cleaning up a mess made by the Obama administration."

So in other words some of the youngest and sickest children will go uncovered, but other, presumably healthier children will get insurance coverage. It resembles the plot of the movie Sophie’s Choice in its calculation: choose one child over another child.

Whether Fallin and Doak are making a prudent decision or not misses the larger point that the profits of health insurance companies continue to dictate major aspects of our medical system. Health insurance companies, of course, want to insure the healthiest people in our society and not insure unhealthy people, such as premature babies, who require extensive medical attention. It’s a calculated business model.

It also shows how broken our health care system remains even after the Affordable Care Act, which strives to increase insurance coverage in the nation, thus eventually lowering costs for everyone. The problem, of course, is that ACA—primarily because of Republican opposition—didn’t include a public option for coverage, which would have eliminated the need for Fallin and Doak to make this stark decision in the first place.

The Oklahoma Hospital Association and the Oklahoma Institute for Child Advocacy oppose the rule change, according to the media report, but these issues will continue to perplex our culture as long as insurance companies are allowed to dictate winners and losers in our health care system. It’s a terrible and costly system. When we cater to it, our costs go up and the level of care does down.

Oklahoma’s Health Ranking Declines

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An annual study shows that Oklahoma’s health ranking has declined.

The United Health Foundation ranks the state 48th in the nation when it comes to overall health in 2011. Last year, the state ranked 46th. Mississippi and Louisiana ranked 50th and 49th, respectively, in the study. Arkansas, the state’s eastern neighbor, was 47th. The number one ranking went to Vermont, a state that has been a forerunner in establishing a single-payer health care system.

It’s easy to dismiss such rankings, which always paint a dismal picture of Oklahoma. The years and the bad health reports go by, and not much ever gets done. Why even acknowledge the obvious? What’s the point?

But it remains important to remind ourselves of the factors that lead to poor health rankings. Even small incremental, positive change is good, though the United Health Foundation ranking shows Oklahoma is going in the wrong direction.

Here are some of the reasons Oklahoma ranks so low:

  • It ranks 49th in the nation in the number of primary care physicians compared to population. This has been a chronic dilemma for the state, which has a rural population that is underserved medically.

  • It ranks 47th in the nation in premature deals, defined as the “loss of years of life lost due to death before age 75.” The study notes, “… cancer, unintentional injury, heart disease, suicide and deaths occurring during the perinatal period are the top five causes of premature death . . .”

  • It ranks 48th in the number of people who smoke on a per capita basis. The overall smoking rate has decreased somewhat over the last two decades, but it still remains a major problem here. Smoking can lead to severe health problems, including cancer and emphysema.

  • It ranks 42nd in the number of children living in poverty, perhaps the most important statistic. When children grow up without adequate health care because their parents are too poor to afford it, they are more likely to develop chronic illness.

The state also has poor rankings in early prenatal care, infant mortality and cardiovascular deaths.

All of this means that Oklahoma is simply not a healthy place to live on a general basis. Obviously, people can choose to live healthier lives—this is the right-wing slogan when it comes to studies like this one—but the state’s infrastructure, from its lack of sidewalks to its automobile-dependent lifestyle, means healthy routines are not built easily into day-to-day living. Poverty also contributes to the poor ranking.

It’s also important to note that the poor health rankings are regional in nature, with states like Mississippi, Louisiana, Oklahoma and Arkansas leading the pack. Texas is ranked 44th. Perhaps, there should be a broader and extensive regional approach to the health care dilemma of all these states.

Many Oklahomans are probably tired of hearing about the state’s poor medical outcomes, but we shouldn’t risk falling into the trap of indifference over an important issue that affects the quality of life for everyone.

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