Democratic lawmakers got a brief preview of Utah's three health-reform plans during a lunchtime caucus Wednesday.
With bit-by-bit disclosure of national health-reform plans and the release of three separate options by a Utah health-reform commission due next month, Rep. Dave Black, D-Salt Lake, said he thinks the ensuing "battle will make the (recent congressional) budget battle look tame."The state's option jury is still ironing out details. But option jurist Rep. Mary Carlson, D-Salt Lake, said the first plan doesn't make many changes to the existing health-care system. It contains portability, meaning it would move with employees to new jobs. Employers will probably be asked to cover half the cost of insurance, and it will call for a "community rating," which means there wouldn't be higher rates for groups of people in specific health risk categories. The plan would revolve around private insurers with little government involvement.
Plan B is a managed competition system. It could be a single-payer system to the extent that the government would gather the financing through taxes, premiums, etc., and pool it to provide coverage.
The third plan is being put together by a coalition of health-care providers who have banded together as the Utah Alliance.
All three plans will be presented in the form of completed legislation that will go to the governor in December and to lawmakers in January.
Focus of all three options has been placed on extending access to health care to all Utahns, on cost control and on maintaining quality.
Utahns need a wide choice of providers, according to Dr. Knox Fitzpatrick, medical director of Blue Cross/Blue Shield of Utah. He said the insurance industry accepts the need for major insurance reform, including antitrust reform, universal coverage and portability. But they are concerned about "fragmentation."
Richard Kennersley, director of the Utah Hospital Association, talked about the Utah Alliance Plan. The fact that so many providers have come together to finalize a reform plan is "nothing short of a miracle," he said.
The coalition will promote a number of reforms, including insurance, tort and legal reforms and a restructuring of the entire health-care delivery system. The plan centers on a managed competition model, with universal access, competing networks and cost controls like reduced defensive medicine and paperwork and rewards for healthy lifestyles. It hopes to "stop the insidious practice of cost shifting," he said.
"Tinkering is not going to fix the system. We've put on all the Band-Aids we can put on."
The alliance plan would phase in over four years.
Low-income advocates prefer a single-payer plan because it guarantees access, according to Utah Issues director Bill Walsh and Joe Duke-Rosati of the Salt Lake Community Action Program.