Rep. Richardson on Health Care

This Legislative Session is scheduled to adjourn June 29, 2007. To meet that goal, the House and Senate leadership must schedule backwards from the adjournment date and set firm deadlines for each legislative phase. Crucial dates are quickly approaching.

This week’s Newsletter topics:
Three phases of a legislative session“”Bill cut-off date approaches.
Status of Health Care Reform“”S.B. 329 Amendments & S.B. 27
OHPC Health Care Recommendations in Rep. Greenlick’s HB 3368.
Rep. Richardson’s April 14, 2007 House Health Care Committee Presentation on H.B. 3341’s Free Market Approach to Health Care Reform

I want to tell you a health care story about my daughter, Rachel. She gave birth to two babies on consecutive days”¦at least that is what the hospital bill indicated.

In early 2004 Rachel and her husband, Mat, were expecting their third child, and wanted to know how much they would need to save to cover their insurance co-payment of the upcoming birthing expense. After some difficulty, Rachel convinced the hospital to give her a cost estimate for an uncomplicated childbirth.

The pregnancy went well and on April 15, 2004 Rachel gave a natural, uncomplicated birth to her third blond-headed, blue-eyed little daughter. Some time later, after the insurance company had paid the majority of the hospital bill, Rachel received her co-payment billing. Her portion was much higher than the estimate, so she called the hospital. The hospital’s bookkeeper said to Rachel, “The insurance company has already paid the bill, so why do you care?” Rachel reminded the bookkeeper of the co-payment still due and Rachel asked for a complete billing to be mailed to her.

Several days later the billing arrived and Rachel reviewed it line by line. She was first concerned when she saw multiple over-the-counter pain pills that she had neither requested nor taken. She was next concerned by an extra day’s hospital charge that had not been incurred. Finally, she was really concerned when she saw full charges for “labor and delivery” for both April 15 and April 16.

When Rachel called the bookkeeper, she was told she must have misread the statement. But after going through the statement together, the bookkeeper finally agreed there were a few mistakes (totaling several thousand dollars) on the hospital bill and a corrected billing would be sent.

Rachel next called her health insurance company. She talked to a clerk and explained that the insurance company had over-paid the hospital by several thousand dollars. The clerk responded that Rachel must have misread the billing statement. After going through the statement, the clerk admitted an overpayment apparently had occurred. Then she dutifully asked Rachel to send her a copy of the erroneous billing statement.

The moral of the story is this, who cared that there was a several thousand dollar overpayment to the hospital? The hospital did not seem concerned that it had received a wind-fall of several thousand dollars. The insurance clerk was not overly-concerned about the mistake; it was not her money. The only one who really seemed to care was Rachel. She cared about how much the co-payments would drain from her family’s bank account, and she felt it was wrong for the hospital to get over-paid at the insurance company’s expense.

If we are going to slow the skyrocketing costs of health care, the one who receives health benefits needs a stake in how much those health benefits are costing.

House Bill 3341’s free market approach to health care reform provides such an interest with a Health Benefit Account (like a Health Savings Account or HSA) used for acute, preventative and chronic care expenses paid at the “point of service” with a Health Benefit Card (debit type medical card), and a high deductible insurance policy on top to protect against catastrophic medical expenses. For an overview, watch my April 14, 2007 Health Care Committee Presentation on H.B. 3341’s Free Market Approach to Health Care Reform. More details to come.

Sincerely,

Dennis Richardson

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Posted by at 07:33 | Posted in Measure 37 | 3 Comments |Email This Post Email This Post |Print This Post Print This Post
  • Bob Clark

    Thanks for the market based healthcare proposal, Representative Richardson. I find insurance policies and healthcare bills to be even more convoluted than the U.S. tax code. I wonder why healthcare communication in these instruments can’t be more transparent like a car repair bill, or even U.S tax form 1040. Does the healthcare industry use fuzzy wordsmithing to avoid tripping on laws or potential lawsuits? Or is it just the nature of the service? Both?

  • Steven Plunk

    I agree with Bob. A market solution is the key to containing costs, insurance reform will solve nothing.

    What other businesses get away with not telling us costs up front? What choices do we have in terms of care? What if we dispute the charges? What if they don’t deliver the promised results? How do we know who is a good doctor and who is not so good? All of these are part of the problem and only market based solutions will solve them.

    Information and doing away with the disconnect between provider and payer will go a long way to controlling costs. Controlling costs will go a long way to making insurance affordable.

  • Caper

    Why isn’t anyone talking about the health care problems in the existing Oregon Health Plan? Why can’t we fix what we broke?

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