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          Front Page




Health Insurance Called Broken

By Winthrop Quigley
Journal Staff Writer
    SANTA FE— A House committee Saturday spent hours hearing from dozens of people that private insurance is at the root of New Mexico's health care problems.
    Supporters of the Health Security Act told the House Health and Government Affairs Committee that giving a new, powerful commission control of health care funding and spending would improve access to care, raise quality and reduce costs. The act, sponsored by Rep. Roberto "Bobby" Gonzales, D-Taos, is House Bill 214.
    Valencia County physician William Pratt said that replacing insurance with a state-mandated fund to pay for most residents' care would reduce administrative costs and allow more money to flow to health care providers.
    Eleanor Chavez, director of the National Union of Hospital and Healthcare Workers Local 1199, said access to care is rationed by today's insurance-based system. Coverage decisions are dictated by insurance companies' need for profit, she said. "We don't want to choose a plan, we want to choose a provider," Chavez said.
    Responding to arguments that insurance creates competition that improves care and lowers cost, Dan James, who said he is a heart transplant recipient who works in Los Alamos, said, "We need to get over the competition paradigm and take care of people."
    The committee rejected the suggestion of its chairwoman, Rep. Mimi Stewart, D-Albuquerque, that the legislators vote the bill out with no recommendation so it can be heard by the House Judiciary Committee. More legislators than House Health and Government Affairs members should decide the fate of the bill, she said.
    Instead, the committee will continue deliberating the Health Security Act and Gov. Bill Richardson's health financing proposals Tuesday.
    Under the Health Security Act, employer- and individual-paid premiums and funds used to support public health care programs would be consolidated into a single fund. That fund, under the control of an unpaid 15-member commission, would pay the health bills of residents not already covered by military, military retiree and federal retiree health plans. Tribes and employers who operate in a number of states would have the option to join the plan.
    The commission would negotiate payment rates with health care providers and operating budgets with health care facilities. It would determine what capital investments hospitals can make.
    Committee members' questions indicated they were concerned the commission and its fund would not be accountable to the Legislature. Mary Feldblum of the Health Security for New Mexicans Campaign said the Legislature could approve the commission's budget and the premiums it charges.
    Rep. John Heaton, D-Carlsbad, who is sponsoring Richardson's Health Solutions proposal, said the Health Security Act would result in "significant rationing of capital" that hospitals need to buy equipment and build facilities.
    Other critics said the act could create provider shortages and require rationing of care when funds are not adequate to pay providers. The state Department of Finance and Administration in its comments on the bill said that "it is unclear how the bill proposes to generate sufficient revenues" to cover beneficiaries.