GOP leaders in the House are reportedly “done” debating Healthy Utah.
Faced with a March 12 deadline for getting the peoples’ business done, and for balancing the budget, House Speaker Greg Hughes, R-Draper, has consigned Healthy Utah to the Rules Committee where it will presumably die.
I empathize with Hughes, who I'm sure has reasons for his decision. The biggest argument House members make against Healthy Utah is the risk of losing control of costs. But as someone steeped in the “risk” business for 44 years, let me propose a different calculus. On a scale of 1 to 10, with 1 being the lowest risk and 10 the highest, here is my own opinion as to the relative risk I’ve had to help manage over the years:
Risk level 3: As a private auditor, and as Utah’s state auditor, I have published opinions on the financial health — the good, bad and ugly — of major corporations and of colleges and universities.
Risk level 4: As assistant director and, later, as director of the Utah Division of Finance, I balanced the state’s books and helped bring its financial reporting into full compliance with generally accepted accounting principles.
Risk level 8: As finance director for the Salt Lake Olympic Committee, I helped manage contracts and finances to ensure there would be no deficit for Utahns.
Risk level 7: Being CFO of a large health system, University of Utah Hospital and Clinics, is profoundly challenging. You have to be budgeted and staffed to adequately cover the health care needs of the community — including during natural disasters and disease outbreaks — without breaking the bank and while socking money away to maintain facilities.
Risk level 9: If that’s not enough, in the period between 2005 and 2014, University of Utah Health Care endured the added challenge of a doubling in our uncompensated, or “charity” care, costs, which now stand at $120 million per year.
By comparison, Herbert’s Healthy Utah 2.0 plan is a no-brainer — not quite a zero risk scenario, but easily a “level 1.” That’s because the state’s hospitals, including University of Utah Health Care, have agreed to contribute $25 million of the state’s hospitals portion of the future bill. In so doing, we alleviate the financial burden related to hospital services on taxpayers and businesses. And we ensure Utah’s federal tax dollars stay in Utah ($3.2 billion that will otherwise pay for Medicaid expansions in other states over the next six years). Those are hard numbers to ignore.
More persuasive, even for a numbers guy like me, is the potential for saving lives by ensuring all Utahns have access to quality health care. A recent study in The New England Journal of Medicine showed three states that have expanded Medicaid (New York, Maine and Arizona) have seen their mortality rate drop 6.1 percent. That’s 19.6 deaths per 100,000 residents who, according to the study, also now face fewer delays in getting care and self-report better health. In the end, shouldn’t that be the litmus test for Healthy Utah 2.0?
There have been times that I and my colleagues have wanted to throw up our hands and be “done” with the Affordable Care Act. Complying with the law — its complicated regulations and safety and quality reporting requirements, too numerous to list here — has been all-consuming for the industry. It’s made my job more difficult and it has cost UUHC tens of millions of dollars, mostly in reduced Medicare payments carved away to fund the president’s signature initiative.
Like the governor, we’ve tried to work with federal officials to find a happy middle ground on provisions we believe distract us from our mission to advance the health of this community. Herbert has secured remarkable concessions from the feds to cover Utah’s uninsured the Utah way. The resulting Healthy Utah 2.0 plan is as close to a risk-free proposal as it gets.
Surely, our leaders in the House and Senate can find the time and political will to reach consensus on this most important policy debate. UUHC doctors and nurses will continue to care for Utah’s low-income and uninsured, with or without reimbursement. That’s their job and their privilege. But imagine how many more mothers, fathers, sons and daughters we could save — the value of which cannot be measured in time or money.
Gordon Crabtree is chief financial officer for University of Utah Hospitals and Clinics.