Lawmakers continued to grapple with Indiana’s high health care costs Thursday as they determined which state measures would help strengthen the free market.
Two state experts testified virtually before the committee, sharing what other states have done and considering options, but lawmakers appeared frustrated with the need to take action. Ta.
“…In a[true]free market, we wouldn’t have to do[this]. In a free market, people would know what to pay for what, and…we don’t have that.” said Sen. Chris Garten (R-Charlestown). “What is sickening to me is that we need to engage with this from a regulatory perspective and legislate transparency.”
Garten opened the meeting by pointing out that Indiana was recently ranked 10th worst in the nation for health care by Forbes magazine, demonstrating the need for continued research and analysis.
“This study should serve as a reminder of why we are here. Hoosiers deserve better,” Garten said.
Brent Fulton, a research professor at California State University, shared policy proposals to address Indiana’s “highly” concentrated health care and insurance markets. The policy proposal builds on a presentation last October on the state’s monopoly.
“When it comes to health care, the biggest issue in the United States is affordability. In fact, we go to the doctor less often, we go to the hospital less often than in other countries…(but) when we go to the doctor, when we go to the hospital… are paying very high prices,” Fulton told the committee.
Lack of competition occurs when systems buy smaller chains, known as horizontal mergers, or networks of physicians in vertical mergers.
States may strengthen their merger review powers. For example, Massachusetts has a commission to review mergers, and the attorney general also plays a role in ensuring competition. After the merger, Mr. Fulton discussed ways to limit anti-competitive contracts, increase price transparency and implement hospital rate regulations.
Fulton acknowledged that there are other options, including establishing a state commission on health care affordability, site-neutral payments, and reevaluating the tax-exempt status of nonprofit businesses, but they are being discussed elsewhere. Mr. Fulton did not expand because he said it was covered. That last point in particular draws attention to Indiana economist Mike Hicks, who notes that Indiana’s largest nonprofit system makes billions of dollars in profits that are returned to local residents. He frequently criticizes investors for investing in the stock market instead of investing in the stock market.
However, each movement has its own drawbacks. Regarding price transparency, Fulton noted that providers will be able to adjust their prices, potentially providing an opportunity for providers who offer affordable procedures to increase prices.
“Government’s role in the markets is to make sure the markets work. These markets are not working,” Fulton said. “There aren’t that many sellers that compete on price or quality.”
States setting prices is a common practice to reduce health care costs in Europe, as was considered earlier this year with a bill that would set prices at 285% of Medicare rates. But selecting a price is “complex” and can easily go wrong if not done correctly, Fulton said.
Instead of setting the price at 285% of Medicare rates, lawmakers ordered the Department of Family and Human Services to investigate where hospitals are located, which at least one national expert thought was a good move. .
“In my opinion, this is a healthy opportunity for hospitals to make profit margins, because of course they need to make some profit,” said Maureen Hensley Quinn, senior director of the National Academy of State Health Policy. Told.
“But in Indiana and across the country, some hospitals are moving away from private plans without a clear understanding of whether it’s actually helping improve quality or if it’s having any effect.” We’re seeing them getting paid four to five times the Medicare rate. They’re just raising the prices.”
The Health Care Cost Oversight Task Force, which Garten directs, will meet again on November 13 to discuss the final report’s recommendations.
