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I don't agree with the title of this Politico article, but it's a decent look at what Washington went through recently in passing the first 'public option' and the implications of that process for looming national reform efforts. And it's timely, given that other states are following closely behind with their own variations of the public option concept (Colorado may be next: Colorado's new public option proposal) and a federal approach, whether conceptualized as a pre-cursor to or a substitute for something more expansive, likely to be on the agenda.
As the co-sponsor of Washington's legislation in the state Senate notes late in the article, the biggest challenge was the backlash from health care providers in response to attempts at cost containment: "'The most contentious issue is going to be, how do you compensate the providers and the hospitals?"' Frockt says."
The One State Taking a Big Run at Health Reform
Interesting nod to the all-in statewide health care cost growth target Massachusetts has been tracking to for the past seven years.
As the co-sponsor of Washington's legislation in the state Senate notes late in the article, the biggest challenge was the backlash from health care providers in response to attempts at cost containment: "'The most contentious issue is going to be, how do you compensate the providers and the hospitals?"' Frockt says."
The One State Taking a Big Run at Health Reform
Cody and Frockt also held out some hope of bipartisan support. Where some other public option plans call for the government to form its own insurance company, an idea many conservatives reject, Washington state would merely define standards for the program and contract private insurers to run it.
Where Cody and other backers suspected they’d get pushback, however, was over the policy's cost-control mechanism. To force down premium costs, Washington’s public option would cap the rate at which contracted insurers could reimburse doctors, hospitals and other providers for treating public option enrollees. The cap is a key point both for the policy itself and for the politics.
In health care policy circles, a reimbursement cap is the heart of a public option plan: In theory, it forces doctors and other health care providers to find ways to lower costs, rather than simply passing on cost increases to insurers, who pass them on to consumers in higher premiums.
One thing Cody and other reformers realize they needed is better data about what health care actually costs to deliver, so legislators know when to hold the line on things like reimbursement rates. Cody says Washington state could benefit from something like Massachusetts's "health care cost growth benchmark" initiative, which tries to drill down into the true costs of the entire health care process—everything from the provider's actual costs and total out-of-pocket costs for patients to net costs for private insurers.
Interesting nod to the all-in statewide health care cost growth target Massachusetts has been tracking to for the past seven years.