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Put consumers in charge of health care

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POSTED: October 2, 2009 9:54 a.m.
Two weeks ago, President Obama presented his health-care proposal to the nation in a joint session of Congress. In the past 50 years, joint sessions of Congress have been called only 15 times.
While I support the urgency of health-care reform, I strongly disagree with him on how to address the problem. The president argues his plan will be self-sustaining, but I’ve never seen the federal government live within its means.
I believe in empowering individuals. The president believes in empowering bureaucracy to solve our health care problems. The answer to controlling health-care costs is found by putting the patient in charge of their own health-care plans.
Currently, the government or the insurance companies control costs. By putting the consumer in control rather than the provider, we will see a natural reduction in costs and improved health through personal responsibility.
Georgia has implemented a consumer driven health plan option for state employees, which is the perfect solution to find savings. The CDHP is a high deductible insurance plan paired with a health savings account with the stated goal of providing both higher consumer involvement in their health-care decision-making and also providing a cost savings to the state.
Employees who choose this option receive preventive care procedures such as mammograms, immunizations and wellness checks for free. The state will provide the first $500 for all other regular care, which can be rolled over to the next year if it is not used. The second $500 comes from the employee. After that, the plan covers 90 percent of catastrophic coverage and the patient is responsible for the rest.
By giving the employee a stake in this decision process, they are incentivized to shop around and make wise choices for their procedures and medications. This saves the individual and the state money in consumer-driven competition. In other plans, the employee has zero reason to care how much a procedure costs once they pay their deductible and the co-pay.
These plans have proven popular. In 2009, approximately 20 percent of state employees moved to CDHPs. Claims data from the health benefit plan show higher compliance rates under the CDHP plans than PPO/HMO plans for several categories of preventive care services including annual exams and screenings for various types of cancer and cholesterol.
At the same time, state expenditures per employee in these plans were more than four percent less than the expenditures per employee in the HMOs, and more than 13 percent less than for employees in PPOs.
Members in the CDHPs also have lower emergency room utilization, lower hospital admissions and spend fewer days in the hospital than the other plans. These significant successes are from putting the consumer in charge of their plan and money. Rather than empowering government and providing a one-size-fits-all bureaucratic system, CDHPs empower individuals with freedom and choice.
We can also find health-care savings by reducing fraud and abuse in the system. The federal government has given the states very little liberty to control abuse ourselves. However, Georgia has found a way and realized significant savings. In FY2008, the State False Medicaid Claims Act (HB551) was passed, and the FY08 budget recognized more than $10 million in estimated state general fund savings. The claims act allows the state to verify income and eligibility for participation in Medicaid.
Putting the consumer in charge of their own health care and cutting down on fraud and abuse are the best ways to reform the health-care system. Consumer-controlled health care works within the free-market system, alleviates government controls, and incentivizes personal responsibility for costs and healthy lifestyles. Washington should learn from Georgia.

Williams serves as the Senate’s president pro tempore. He represents the 19th Senate District, which includes Long County and part of Liberty. He can be reached at 404.656.0089 or by email at tommie.williams@senate.ga.gov.

 

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