Utah, not D.C., points the way for Georgia on health reform
When a judge last month declared ObamaCare unconstitutional, many people in Georgia and the other states suing to overturn the law wondered if they had been freed from its onerous taxes and regulations.
Georgia could stand pat, gambling that the ruling will hold up on appeal. A more prudent tack is to copy a reform model that predates the federal law — and might satisfy it.
Utah created a health-insurance exchange in March 2009, around the time President Barack Obama began his health-reform push. A pilot version was in place later that year, and last fall the exchange went statewide. More companies in Utah offer health insurance to workers now. And they didn’t get subsidies to do it.
Utah’s exchange gives consumers information about plans and helps them enroll in one. Crucially, it allows them to pool health dollars, whether from their employer(s) or their own money, as never before.
“It’s the easiest idea in the world,” says Cheryl Smith, who helped launch Utah’s exchange and now works with other states that want to do the same. (Georgia is not a client, though state leaders are interested in starting an exchange.)
The ability to pool money is key. Smith says most of Utah’s uninsured were employed, but many of them worked multiple part-time jobs and didn’t qualify for health benefits.
For those individuals, Smith says, “if Employer A gave $300 and Employer B gave $200 … we could combine those contributions and help them get a plan.” Both employer and employee can do this with pre-tax money.
Pre-existing conditions aren’t a factor because the exchange helps insurers mimic the size, stability and randomness of large risk pools. In turn, the exchange adjusts the premiums insurers receive for the risk they take on with consumers who have, say, diabetes.
“This is really what most states need,” says Grace-Marie Turner of the Galen Institute, a think tank that promotes free-market solutions for health care. “It allows insurance to be portable because the insurance is owned by the individual.”
State exchanges are also a feature of ObamaCare. But while its requirements for those exchanges are still in the works, they’ll likely be more burdensome than what many states would design. Turner predicts low-premium, high-deductible plans — popular on Utah’s exchange — will be scarce.
The Obama administration’s concept of an exchange is closer to what Massachusetts has done, including the insurance mandate for individuals and subsidies, than Utah’s model.
The Massachusetts plan has attracted more participants than Utah’s — “When you’re giving it away free, it’s not hard to get people to join,” Smith says — but at a far greater cost. The budget for the Massachusetts Connector in Year 1 was $25 million, growing to $30 million. In Utah, the respective figures are $600,000 and $675,000.
But back to the lawsuits moving through the courts. If ObamaCare survives the legal challenges, a state that hasn’t planned its own exchange may not have time to catch up. The consequence: The feds would set up and run an exchange in that state as they see fit.
But if a state already has an exchange that “is getting good results, and they can see that people who are formerly uninsured are becoming insured,” Smith says, “I would hope [the federal government] would have the wisdom to let a state continue to do that.”
Wisdom from Washington? Sounds like a stretch, but it’s worth a try.
– By Kyle Wingfield
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137 comments Add your comment
Michael H. Smith
February 27th, 2011
5:29 pm
Hmm… let’s see: Uh, Um… Oh, maybe because the list contains Unions which first of all have better healthcare under their contracts already than Obamacare lawfully allows a person to have without penalties and then you don’t think just maybe $200 to $400 million in campaign contributions to the corrupt dear leader Obumer & his corrupt Democrat Company from Unions bought them any Qid Pro Quo influence do you?
Those wavier weren’t granted, they were bought and paid for in advance with union dues money.
Linda
February 27th, 2011
6:02 pm
Michael@5:29, You forgot another possibility. Maybe they could not AFFORD Obamacare. Hmm?
It was $2.4 M in ‘08 & $2.3 M in ‘10 by the Teamsters & $2.6 M in ‘08 & $1.7 M in ‘10 by SEIU to Democrats in campaign contributions, which do not include all the advertising & “field” work such as busing protesters to private homes to scare the living daylights of children hovering inside in closets.
That’s our tax dollars at work!
catlady
February 27th, 2011
6:34 pm
I would posit that one significant difference between Utah and almost everywhere else is that the majority of the businesspeople in Utah are devout Mormons. They feel an obligation to do for their employees (who make the business possible).
In Georgia and many other places, there is an ethos that “You are on your own. Don’t cut into MY profit.” And, “If you don’t have (fill in the blank) it is YOUR fault. I got mine.” Although the people of Georgia claim to be Christian, it doesn’t extend to their pockets. You have only to read the spittle that flies on this blog to see examples.
If I get to use Medicare, it will be 6 1/2 more years. I will have paid into Medicare for 45 fully working years. Yet I plan to be very thankful for it, in contrast to so many of those using in now who rail against “socialized medicine.”
I think there are things that all people should have: clean air, water, and food; an opportunity for obtaining an education, health care to a sensible degree, safe housing, work for those who will work hard.
Sensible health care does not mean “I can abuse my body and you have to patch me up,” but does mean there are basic opportunities for taking care of our health that should be available to all.
catlady
February 27th, 2011
6:49 pm
My neighbor, a rabid Tea Partier, rails against being forced to buy health insurance. He “doesn’t need it.” He is 55, weighs in at 325, and does no preventative health care, even dental work. He pays cash when he goes to the doctor (less than $50) and gets whatever medicine he needs by bugging the doctor for samples. When he gets very sick (happening more frequently now) he goes to the ER and has them write off his bill because he is “indigent.” Yes, I guess he “doesn’t need” health insurance.
Linda
February 27th, 2011
6:55 pm
Catlady@6:34, You are wrong. According to Forbes, the Georgia people were # 8 in charitable giving, after Utah, Maryland, NY, Conn., CA, Hawaii, & NJ. Try it on a population basis & it is even more stunning.
http://www.forbes.com/2005/11/23/most-charitable-states-cx_lh_1125home_ls.html
May God bless those who give, not to the govt., but to the needy.
Linda
February 27th, 2011
7:09 pm
Catlady@6:49, Since the new hc bill requires the purchase of a hc policy OR the payment of a fine, & since paying the fine is cheaper than buying the policy, what motivation will your neighbor have to buy a hc policy & change his current health care regime? If your overweight neighbor develops an attributable condition, such as diabetes, a stroke or a heart attack, since the new hc bill covers pre-existing conditions, what motivation will your neighbor have to buy a hc policy before his trip to the ER in the ambulance?
Gaming the system will continue with the new hc bill.
Linda
February 27th, 2011
7:10 pm
catlady, sorry I spelled your handle with a capital “c.”
Michael H. Smith
February 27th, 2011
7:15 pm
Aren’t you glad that Georgia is a “right-to-work” State, Linda?
GEORGIA
TITLE 34. LABOR AND INDUSTRIAL RELATIONS
CHAPTER 6. LABOR ORGANIZATIONS AND LABOR RELATIONS
ARTICLE I. GENERAL PROVISIONS
§ 34-6-6. Compelling persons to join, or refrain from joining, labor organization, or to strike or refrain from striking.
It shall be unlawful for any person, acting alone or in concert with one or more other persons, to compel or attempt to compel any person to join or refrain from joining any labor organization or to strike or refrain from striking against his will by any threatened or actual interference with his person, immediate family, or physical property or by any threatened or actual interference with the pursuit of lawful employment by such person or by his immediate family. (Enacted 1947.)
http://www.nrtw.org/c/gartwlaw.htm
Michael H. Smith
February 27th, 2011
7:26 pm
I would truly love to get involved with a few good Conservative lawmakers in this State to design a healthcare program that would do justice to real healthcare reform. The worst comments I read on this blog come from the zero-sum game, mostly the BIG GUB’MENT dependent, thoughtless left. Of course, that doesn’t leave out the other left side of the left, spelled with a very Big Business laissez-faire capital “L” Libertarians
Michael H. Smith
February 27th, 2011
7:50 pm
If you want abuse catlady, try standing in the check out line at some Kroger store behind a 300 lb. female that is purchasing a shopping cart full of nothing but ice cream and more ice cream on top of frozen sugary sweet Lil treats, when she whips out an EBT card and a handful of WIC vouchers to pay for all that darn junk food, at partly your expense, with the full knowledge that whereby you are also partly soon going to be paying for her Type 2 Diabetes or Heart Attack or Stroke through Medicaid. Thereafter, probably partly paying for her funeral expense too.
This is why people spew and fume to no damn end about your beloved BIG SOCIALIST GUB’MENT so-called safety net and/or entitlements.
If it were up to me, anybody that received one penny of State money for food would first see a doctor for an evaluation and if they are obese, have a eating disorder or any health issues that would require a life change in their diet, they would only be able to buy with taxpayer money the foods prescribe by the doctor based on the doctor’s examination of the applicant.
Yeah, 300 lbs and eating nothing but ice cream bought with taxpayer money !
Linda
February 27th, 2011
7:54 pm
This is a govt. website that lists unemployment rates by states as of 12/10. Of the 10 states with the lowest unemployment rates, 6 are “right-to-work” states. There are 22 right-to-work states, with the list growing in ‘11 & ‘12.
http://www.bls.gov/web/laus/laumstrk.htm
Michael H. Smith
February 27th, 2011
8:07 pm
Zogby Interactive: Majorities Say States Can Cut Employee Salaries & Void Collective Bargaining Agreements
UTICA, New York – Two-thirds of likely voters agree that state legislatures have the authority to cut state employee salaries and 52% agree they can void collective bargaining agreements to reduce spending.
Voiding collective bargaining agreements is also seen as preferable to continuing to pay state employees at current levels or layoffs of state workers in order to reduce spending and control deficits.
These results come from a Zogby Interactive poll conducted from Feb. 18-21, 2011.
http://www.zogby.com/news/ReadNews.cfm?ID=1950
Linda
February 27th, 2011
8:11 pm
Michael@7:50, Hey! Either you & I shop at the same Kroger or there’s twin sister shoppers. The ice cream lady at my Kroger leaves in a black Lexus with a full trunk & back seat. What about yours?
I don’t get carded any more except when I buy ice cream for our son. Kroger tells me I’m too OLD to buy Death By Chocolate, etc. I have to sign an affidavit promising my husband & I won’t indulge. Wonder why Lexus/ice cream lady has more entitlements than I do.
The country has been in trouble since entitlements outnumbered rights.
Mr_B
February 27th, 2011
8:17 pm
Linda @ 7;09. Linda, you can pay for the insurance and get coverage. You can pay the fine and get, well, a fine. Not too tough a decision.
You are correct when you state that “gaming the system” will continue, unless human neture takes a sudden turn for the better, which is unlikely. That is no excuse to leave in place a system that produces poor outcomes at a cost of about one seventh of our GDP, far above what any of our international competitors pay.
I will agree that the current Affordable Health Care Act is deeply flawed. I also submit that it is much better than doing nothing, which evidently was the conservative approach.
What is really needed is a system that recognizes that health care ( at least at some minimal level such as maintaining life and mobility)is a right and not a commodity; and develops a method for all citizens to share equitably in its cost, the same way we share in the cost for providing a common defense
Linda
February 27th, 2011
8:24 pm
Michael@8:07, What is the difference between authority & audacity? Don’t go there.
I don’t plan to watch the Oscars tonight. I don’t care about trophies, stars, movies, designer dresses, expensive jewelry or red carpets. I do like shoes, however. Democrats will be watching it to see how their meal tickets/sugar Daddies are doing. Those darn millionaires & billionaires! Envy & jealousy! Tax their greedy souls!
Mr_B
February 27th, 2011
8:33 pm
Michael: are you suffering from ice-cream envy? Would you swap lives with the woman in your anecdote? You know nothing about the woman or her circumstances, but you are willing to condemn her based on a two minute interaction in a shopping line? What “abuse” did you suffer?How about the dairy farmers whom her purchase helps support? Are they not also the recipient of welfare?
Mr_B
February 27th, 2011
8:34 pm
And with that, this lazy overpaid public employee needs to go to work…..
Linda
February 27th, 2011
8:39 pm
Mr._B@*:17, It was part of the Dem. strategy to intermingle the term “health care” with the term “health care insurance.” They are not one in the same. Health care has not been denied to anyone for decades & is therefore recognized as a right.
Health care insurance is a commodity, not a right, just as auto insurance, life insurance, credit life insurance, hazard insurance, etc. They are all commodities.
Furthermore, health care insurance does NOT provide or guarantee health care. What the Dems. failed to do in the bill was to MANDATE doctors to accept/see new patients, especially the 15 M new Medicaid patients. With the shortage of doctors & their refusal to add new patients they cannot AFFORD to treat, patients will continue to visit the ER for routine care.
The hc bill solves NO problems but compounds debt problems at both the natl. & state levels.
Linda
February 27th, 2011
8:50 pm
It just came to me today. Is it possible that all liberals/Dems. on this blog are govt. employees & that all the unemployed (who hate entrepreneurs/companies/corporations) on this blog are also liberals/Dems.?
Michael H. Smith
February 27th, 2011
8:51 pm
Can’t say what my ice cream lady has for transportation, Linda. It is a given that whatever she has, it has to be bigger than mine. Since we taxpayers are buying what she eats for food her means of transportation is probably better and more costly. I buy real food with my own real money and because I’ve taken it upon myself to make the necessary “life changes” in my diet to have better health, which aren’t cheap by the way, I have less money to buy other things like luxury cars. What ever vices remain I pay for those at my expense and I don’t run to the doctor just because I have insurance and can do it, like so many that abuse a company co-sponsored privilege. My wife and I are very frugal, common practical sense people out of necessity and necessarily from being responsible self-reliant adults. That’s probably why you and yours, like me and mine don’t have EBT cards, WIC vouchers, Medicaid and live in a section 8 house. We grew up, out grew mommy and daddy while the children that just grew older in this society, who never out grew their need of a mommy and daddy remain under the care of the Nanny State.
Furious Styles
February 27th, 2011
8:55 pm
Utah?? There moronic alcohol laws are even worse than Georgia’s, and someone has an idea to follow their health care law. Maybe we”ll all have to buy a health license before we can go to the emergency room much like htey have to buy a license to purchase a beer. No Thanks!
Michael H. Smith
February 27th, 2011
9:06 pm
What abuse did I suffer?
Brucie is that you? Never mind, it’s you alright.
Hey Brucie, I helped pay for part of that darn ice cream and most likely have to pay for part of her Medicaid and section 8 housing too and you say I have envy and shouldn’t get pissed with this foolish person.
Only a life long GUB’MENT Union employee like you could defend a 300 lb obese leech, I’m sure out of professional courtesy. Always room at the old public trough, aye Brucie?
Linda
February 27th, 2011
9:21 pm
Michael@8:51, “Life changes” in your “diet to have better health” should not be costly. Without divulging info, let me just say that I’m “certified.” I hope you’re not talking about organic foods. The only difference between organic foods & regular stuff is that they are more expensive, are bad for the environment & tend to have more bugs. They are NOT more nutritious.
You have no idea what frugal means. I pay out lots of money to workers but live like a cat. I know tricks you have never heard of.
Edie
February 27th, 2011
9:36 pm
For a state that hasn’t given a damn about setting up a high risk pool ( to save lives), this would be a way for Georgia to demonstrate it truly cares for its own. About time!
Darwin
February 27th, 2011
9:54 pm
If you’re really serious about reforming our broken health care system and reducing the burden that the uninsured place on the insured and taxpayers, stop calling it Obamacare. You show your lack of objectivity and intelligence when you can’t simply debate an issue on its merits. When will the right stop using slurs and incitful words toward anything that doesn’t originate with them? Such a total lack of maturity, KYLE.
Michael H. Smith
February 27th, 2011
9:58 pm
Nope! No organics. Just a lot of fresh veggies, fruits, nuts, grains, very low saturated fats, low sodium (though my sodium is fine) higher levels of mono and polyunsaturated fat meats: Fish, Chicken and Turkey. NO RED MEAT, fewer eggs and now small amounts of very lean pork often mixed with lean Chicken or Turkey when I want flavor with less saturated fats.
Basically what is often referred to as the “Mediterranean Diet” .
Oh and since you’re certified Linda, you will probably agree with this tip I’ll pass along to the folks that want to get rid of belly fat. Try adding Kale to your diet. When chopped up very fine in a food processor (without the stems) it can be added to make a killer tasting Cole Slaw and it is easier to eat fresh uncooked that way. Kale is known as a super-food better than Broccoli or Spinach and it has proven cancer preventing/fighting benefits. It is said to be one of the few foods that make you lose belly fat. Well, it worked for me and my wife. We both had to buy new clothes, my waist dropped down two sizes and the skinny jeans fit just fine.
Sorry Jenny 20
Linda
February 27th, 2011
10:22 pm
Michael@9:58, I’m proud of you. When I was pregnant over 2 decades ago, I contracted Compulsive Obsessive Disorder, which my husband & I love. I’m compelled to cook my way thru cookbooks. I don’t cook anything without a recipe & I’ve never cooked the same recipe twice, except on Xmas Day. Did you know you could cook green beans over 2000 different ways? I make everything from scratch, even my own flour, from grains, in a $350 blender. Without saying, I bake my own breads. Dinner isn’t complete without a green, yellow & white plus a salad. I have 3 food processors on my counter because I refuse to wash them by hand.
Michael H. Smith
February 27th, 2011
10:28 pm
A high risk pool at a very high risk price?
That is were Rep. Dr. Price and I have have problems with his healthcare proposal. If you solely lump the high risk in a group there is no low risk group present to offset costs and bend the curve. Secondly, there has to be incentives to make those in high risk want to make life changes with means available that work to achieve the goals of healthier living, thereby lower their risk.
What I did notice about the Utah(care) plan was their PCN – The Primary Care Network. If Georgia were to create a mutual healthcare insurance CO-OP along this line and they gave ownership and control of the individual’s policy to the members and not the State with the ability to use the health department facilities, that with a few other items added, would bend the cost curve.
No matter, the State can do it better than the Federal Government and by Constitutional authority only the State should do it. Obama and the Democrats overstepped the Constitution, plain and simple.
Michael H. Smith
February 27th, 2011
10:46 pm
A very complete Italian meal would be green, white and red. Saute’ some Kale to a semi-tender wilt, add a can of white kidney beans and a can of Italian style tomatoes let it all simmer, cook until done(to your satisfaction). Use your favorite Italian spices or Sicilian spice which is what I use, sprinkle on a little Parmesan over the mixture. Served with Italian sausage, turkey or your choice, some good bread, salad on the side maybe a glass of wine…
Mamma Mia… Mwha
Michael H. Smith
February 27th, 2011
10:51 pm
Well, I tried to give you a very good Italian green, white and red recipe but the AJC didn’t allow it to be posted Linda.
michael szedon
February 28th, 2011
3:13 am
“Free-market” health care solutions are a big part of what has gotten us the hyper-expensive-yet-mediocre-in-care position we are in. The problem is that pre-existing conditions call for huge premiums, long-term waiting periods for coverage for those conditions, and large deductibles.
“Free-market” is code/slang for what the insurance companies can get away with, for how much will people REALLY pay, and for how many people can we deny coverage to because they will actually NEED it.
Anyone who believes that the free market will regulate it’s policies and prices to include people who actually NEED insurance has either never been sick or injured, or they can afford to pay exorbitant fees for mediocre care.
JF McNamara
February 28th, 2011
8:58 am
If this is such a good idea, the why didn’t the Republicans propose it as an alternative to begin with? Its obviously not something they were interested in as they presented no real healthcare plans during the the debate completely failing to do their jobs. Just sayin…
Peter
February 28th, 2011
9:21 am
Looks like Republicans want to tax all kinds of services…… Kyle the Republican’s are truly the taxing party !
Today’s AJC will tell the story.
Logical Dude
February 28th, 2011
12:22 pm
“The ability to pool money is key.”
So, a Single Payer system would be the most efficient, wouldn’t it?
Idle Remarks
February 28th, 2011
1:50 pm
Far too complicated for Georgia politicians. And yes, Obamacare is a word just a Reaganomics is a word. Idiots.
Tea Partiers are Suckers
February 28th, 2011
2:45 pm
A CEO, a tea party activist, and a union employee were sitting at table with a plate of a dozen cookies sitting in the middle of it … The CEO grabs 11 cookies and tells the tea partier “Watch out, that union guy wants a piece of your cookie.”
independent thinker
March 1st, 2011
8:00 am
The greed of doctors and big pharma needs to be curbed . Look at Israel- they have universal heathcare but it is not run by the government. They have competing HMOs and everyone must join one. The government subsidizes membership based on need. The HMOS must provide a certain level of minmal healthcare determined by the government. Anything else someone can pay a private doctor. The doctors who are part of the HMO have salaries set by the HMO and they are less than in the US. Their health care standards rank higher than in the US. The cost of membership is much lower than health insurance in the US. It is similar to the health care exchanges being proposed in the US but the key is the doctors have a direct employment relationship with the HMO.