Yep. That is just (one) of the facets of a multi-faceted problem. I participated, in a limited manner, in a think tank lead by Tom Daxon. He had been commissioned to put some serious thought into the "problem". The guy is brilliant; this is just a short excerpt from his work. If anyone is actually interested I can point you to the published book.
OCPA's New Health Care Plan Provides Market-Based Solutions
May 05, 2008
By Tom Daxon
In our efforts to help the less fortunate, we have created a jumble of uncoordinated programs, most of which cater to just a limited part of the overall problem, such as a lack of food, housing, or health care. The result is that too often, our attempts to help the less fortunate prove counterproductive. In many cases, the poor would be better off if we did nothing.
At the same time, the outwash of our poorly designed programs causes real economic damage. The current crisis in the sub-prime mortgage market is one example. The crisis in health care and health insurance markets is another.
We should begin by asking ourselves what is of primary importance. When we do, we will find that to solve our most vexing health care policy issues, we must look beyond our health care policies and toward a bigger picture. If we could resolve the problems facing lower-income Oklahomans, most other health care issues we face become much easier to address.
What is that big picture? What can give a child seemingly locked in an endless poverty cycle a legitimate hope of a better life?
The most important asset in a child's life is receiving the love and care of a secure, stable family. Having a father in the home is more important than money or social standing. Having a father in the home is more important than participating in a well-designed social program.
A child from an intact family is less likely to become involved in crime, less likely to be a victim of violence, and more likely to excel in school than a child raised without a father in the home. This remains true even when the results are controlled for race, income, or the education level of the parents.
Yet, under our existing safety net, a poor woman who becomes pregnant will usually find that she benefits financially by not marrying her child's father. The father's income is considered in determining eligibility for assistance that may be more financially valuable than that income.
In addition, that woman will also find that if she exhibits initiative and works hard at a job, her reward will often be a promotion and a raise, leaving her worse off than before. Why? The programs that attempt to assist the less fortunate do not coordinate with each other. A $200 per month raise can result in losing $300 of benefits (food stamps, housing allowance, earned income tax credit, Medicaid, day care assistance, etc.). What's more, the $300 of benefits is tax-free while the $200 raise also leads to higher payroll and income taxes.
Some of the changes we need to make will require a change in approach at the federal level. Others would work better under more enlightened federal policies. However, there are many steps Oklahoma can and should take to minimize the problems caused by Washington and to improve health care delivery in Oklahoma.
To that end, OCPA has undertaken extensive research and is producing a detailed plan called the Oklahoma Comprehensive Health Independence Plan (O-CHIP), of which I am the principal author.
O-CHIP is a comprehensive proposal with simple fundamental concepts:
Strengthen families and encourage their stability.
Reward initiative.
Deregulate insurance markets and open the way to more value-added products.
Make health insurance affordable for every Oklahoman.
Reward Oklahomans who acquire health insurance, penalize those who don't.
Reward participants who help the Medicaid program save money.
Remove barriers to wellness and encourage preventive care.
Empower patients to be better health care consumers.
Achieve better coordination among state-funded health care programs.
O-CHIP recognizes that our health care system works best when everyone has health insurance or other non-government means to pay for care. O-CHIP addresses these concerns by (1) dramatically deregulating the health insurance market and (2) providing assistance for low-income individuals by helping them buy health insurance.
By deregulating the health insurance market, O-CHIP will significantly lower health insurance premiums for most Oklahomans. Individuals will benefit from reduced health insurance premiums, and Oklahoma businesses will become more competitive.
Those who refuse health insurance and have no other means to cover their health care bills create a cost burden for others. Health care providers, especially hospitals, are forced to shift the cost of care to responsible parties who pay their bills. O-CHIP favors those who act responsibly and discourages freeloaders.
Oklahomans who maintain health insurance through their employer or a personal plan receive significant tax relief. Under O-CHIP, those without health insurance will pay higher taxes, find loans more difficult to obtain, and be prohibited from playing the state lottery.
O-CHIP enlists Medicaid participants to help hold down costs. Providing audited information about quality and price empowers them to be better consumers. Those who spend wisely and help taxpayers will be able to keep some of the savings they generate to use as they see fit.
Similarly, O-CHIP makes changes in the rules affecting long-term care. O-CHIP blocks many loopholes that allow prosperous families to foist the care of their elderly members on the state. Conversely, families who help the state control costs are rewarded.
O-CHIP addresses the need for new doctors and other health care professionals, especially in rural areas. To ensure maximum health care resources, O-CHIP funds local hospitals to provide medical school and other scholarships in exchange for service after graduation.
O-CHIP recognizes that healthy individuals require less costly health care. Accordingly, O-CHIP provides reasonable protection to employers who offer wellness and fitness programs to employees.
We can make real and significant progress toward solving our health care problems. Members of both political parties have expressed a desire to make needed changes. Indeed, on May 1 House Speaker Chris Benge announced his intention to form a task force to study the issue of the uninsured and of growing health care costs in Oklahoma. "We want to take a comprehensive approach as we look to reduce the growing number of Oklahomans who do not have health insurance," Speaker Benge said. "We will look to contain health care costs through market-based solutions like supporting personal control over health care expenditures and expanded consumer choice and competition."
The stage is set for Oklahoma to take another important step forward in creating a better climate for growth and opportunity, and OCPA is poised to be a key part of the process.
Tom Daxon (M.S., Oklahoma State University) is a CPA who has served as Oklahoma's state auditor and inspector and as secretary of finance and revenue under Governor Frank Keating. The complete O-CHIP study will be released this month.
