By Charlotte Roybal
Executive Director, Health Care for All Campaign
The Human Services Department's recent press release noted that it had increased Medicaid enrollment in August by over 3,000 without any mention of the fact that for June and July of 2007, the two previous months, more than 16,000 enrollees were dropped from the Medicaid rolls (source: Monthly All Client Eligibility Report, Year/Month by COE, HSD). In fact, there were fewer total enrollees at the end of August than in June.
In addition, Mathematica Policy Research Inc. recently supported the HSD claims of improvement with numbers for which no background information or analyses were provided resulting in two articles in the Journal: "Health Proposal's Cost Lowered"; "Uninsured Rate Decreases in N.M." by Winthrop Quigley on Tuesday, Dec. 18. At a hearing on December 17, it was reported that New Mexico's uninsured rates had dropped from 25 percent to 18 percent in 2007. These conclusions are not supported by published HSD numbers.
These issues and the use of numbers appears to make a political point in an election year, which makes it clear to advocates that we need independent oversight of our health care system. The proposed Health Care Authority, with responsibility to oversee and be accountable for shaping the outcomes of the $6.6 billion dollar health care expenditures in our state, is intended to meet this need. Such an authority should be independent of political pressures but accountable to the governor, the Legislature and the public— and should use evidence-based decisions to drive policy and change in our system.
The Health Coverage for New Mexicans Committee cost analysis of 2006-07 made several important points. First, there are administrative cost savings to be had in both the public and the private sectors. Second, that by merely eliminating administrative costs, we could not be assured of a sustainable system— hence the need for an authority that would reform the delivery system as well. Third, if New Mexico did nothing, our system would cost $2 billion dollars more in five years and would still have to meet the needs of even more uninsured New Mexicans.
The Health Care for All campaign participated in the Health Coverage for New Mexicans Committee. A key committee recommendation was the creation of a Health Care Authority with the responsibility of immediately addressing health policies that would go beyond the limits of the cost analysis that was completed and would support structural health care reform with the goal of delivering universal health care to all New Mexicans. The governor's Health Solutions Plan also proposes an authority to oversee health care reform— but under his control and appointment power. Furthermore the Health Solutions Plan proposes the implementation of selected recommendations and findings for the Health Authority, which leads one to conclude that the administration has made decisions for the authority without the analyses and data necessary to arrive at these decisions. Our concern is that many decisions will become entrenched in current practice and law without any consideration of future needs and possible changes in our health delivery system.
The Health Care for All approach calls for the establishment of a Health Care Authority, and we concur that it would actively reduce administrative duplication and waste in the system. However, our vision of the scope for the Authority is that it would determine the extent of the reforms needed in the health insurance system to meet new health care policy needs. Our position, in addition, has been that the Health Care Authority should be charged to reform insurance through careful analysis, so that we can finally end the process of legislating decisions which have no basis in fact.
With recent events, the Health Care for All Campaign is convinced that transparency in decision making is vital to any health reform process. Our current system appears incapable of providing this (and in this we hold the public system as well as the private sector equally responsible), and we urge the public to make their voices heard to support our call for independence and transparency as proposals for change emerge in the 2008 legislative session.
The Health Care for All campaign stands for legislation for the 2008 session that would create an independent Health Care Authority to oversee health care reform in New Mexico. The Authority should not be appointed by one body of government but should have a clear balance of power. The Authority should report to the governor, the Legislature and the public. Its charge should be to create an action plan which includes legislative recommendations to the 2009 Legislature that would commit New Mexico to achieving health care for all people living in New Mexico. We believe that true reform is possible and that the foundations for reform can be laid in our next legislative session.
The Health Care for All Campaign represents 12 New Mexico advocacy organizations.
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