{"id":17180,"date":"2017-04-16T23:06:26","date_gmt":"2017-04-17T05:06:26","guid":{"rendered":"http:\/\/lastbestnews.com\/site\/?p=17180"},"modified":"2017-04-16T23:06:26","modified_gmt":"2017-04-17T05:06:26","slug":"3-bills-aim-at-state-control-of-health-care-practices","status":"publish","type":"post","link":"https:\/\/montana-mint.com\/lastbestnews\/2017\/04\/3-bills-aim-at-state-control-of-health-care-practices\/","title":{"rendered":"3 bills aim at state control of health-care practices"},"content":{"rendered":"
\"Smith\"<\/a>

Freddy Monares\/UM Community News Service<\/p>

Sen. Cary Smith, R-Billings, has introduced a bill that would allow for direct care agreements between providers and patients.<\/p><\/div>\n

HELENA \u2014 With the future of health care on the federal level still unclear, Republican lawmakers in Helena are pushing legislation that could reshape how Montanans access and pay for medical services.<\/p>\n

Three bills\u2014House Bill 266<\/a>\u00a0and Senate Bills 100<\/a> and 362<\/a>\u2014are based on the premise\u00a0that individual states should be able to determine what health-care practices are best suited for their residents, and that costs should be lowered.<\/p>\n

\u201cFinally a handful of legislators on both sides of the aisle are starting to target what we view as the real issue\u2014the cost of care,\u201d said Brent Mead, executive director of the Montana Policy Institute, a free-market think tank, in an email.<\/p>\n

The bills seek to tailor health care coverage to Montanans in different ways.<\/p>\n

Senate Bill 100, introduced by Sen. Cary Smith, R-Billings, would allow for direct care agreements between providers and patients, allowing patients to pay for treatment outside the confines of insurance.<\/p>\n

Senate Bill 362, introduced by Sen. Ed Buttrey, R-Great Falls, would require pricing transparency from health care providers, and would also require them to create \u201ctransparency tools\u201d that display treatment costs, allowing consumers to compare prices.<\/p>\n

HB 266, introduced by Rep. Nancy Ballance, R-Hamilton, would create a compact of like-minded states that would lobby Congress yearly on health care issues.<\/p>\n

<\/b>Each of these bills in some way takes a market-driven approach to health care.<\/p>\n

\u201cThe fundamental principle of market reforms in health care is to get consumers more information on cost and quality earlier in the process,\u201d Mead said. \u201cOnce patients can make informed choices that best fit their needs, then you will see providers respond to the changes in behavior.\u201d<\/p>\n

Mead said the conservative approach of focusing on cost more directly helps Montanans, and that a Medicare-for-all approach would simply shift who pays.<\/p>\n

The latter option, he said, would \u201cchange who pays, and how individuals are covered, but health care spending will continue to go up and will continue to consume an unsustainable share of the economy.\u201d<\/p>\n

HB 266 is a direct effort to return power to states.<\/p>\n

\u201cIt just \u2026 makes sense that you have a health care system that works for 300-plus million people, that there\u2019s a lot of stuff in there that you don\u2019t necessarily need for the million-some people in Montana,\u201d Ballance said.<\/p>\n

\"CapreAir_Variable\"<\/a><\/div><\/div>\u201c[Congress is] beginning to talk about this compact as a way for states to request their authority back,\u201d Ballance said. \u201cMaybe states really are kind of those places that can experiment a little bit, and try some things with health care.\u201d<\/p>\n

Ballance said her bill would bring together 25 or more states to annually lobby Congress to demand autonomy for developing health care plans.<\/p>\n

\u201cIf you get a plurality of states, then they have a hard time ignoring you,\u201d Ballance said.<\/p>\n

Ballance said the states would meet to discuss specific issues they have with the federal health care system. She said, for example, that states could request their share of Medicare, Medicaid or Children\u2019s Health Insurance Program funding to experiment with their own unique plans and methods of coverage.<\/p>\n

\u201cIt\u2019s a way to bring it back, the authority and the money back to the state,\u201d Ballance said.<\/p>\n

She said the failures of federal health care systems primarily rest on the fact that they don\u2019t first address the market.<\/p>\n

\u201cEvery time we run afoul of that, the government has to keep trying to fix it,\u201d Ballance said. \u201cIn the process, they usually break something.\u201d<\/p>\n

Health insurance as we know it in the United States functions as a risk pool, where individuals pay in, often through their employer, and withdraw money when in need of a medical procedure.\u00a0But SB 100 would take\u00a0a different approach.<\/p>\n

SB 100 is the bill that allows individuals, independent of insurance plans, to enter into a contract with physicians, physical therapists, or any other kind of provider to pay for treatment directly.<\/p>\n

\u201cThis is not insurance,\u201d said Sen. Cary Smith, R-Billings, the bill\u2019s sponsor. \u201cThis is more like a situation where you have an agreement with DirecTV, where you\u2019re going to buy a service for a certain amount of money.\u201d<\/p>\n

A version of SB 100 was introduced in 2015 by now-State Auditor Matt Rosendale, but was vetoed by Gov. Steve Bullock. Smith said he brought the bill back because of changes proposed by President Donald Trump, as well as what he sees as an ineffective health care system.<\/p>\n

\u201cAs you try to buy that insurance, we\u2019re hearing things from our constituents like \u2018my insurance payment now is higher than my mortgage payment,\u2019\u201d Smith said.<\/p>\n

As SB 100 attempts to push health care outside the realm of insurance, others are seeking to bring the overall cost down through transparency measures.\u00a0Buttrey said his bill, SB 362, treats health-care pricing like other markets.<\/p>\n

\u201cImagine if car dealers didn\u2019t have to post the price of their car,\u201d Buttrey said. \u201cAnd you simply went and said, \u2018I need a four-door sedan,\u2019 and then a month later you got the bill.\u201d<\/p>\n

HB 362 bill originally provided a financial incentive for patients who shop for lower prices and go with the cheaper option. That, however, was taken out of the bill when it went to the House after it was opposed by insurance providers.<\/p>\n

Jennifer Hensley, representing PacificSource health plans, opposed the bill because of that \u00a0provision for incentives, despite supporting the idea of transparency.<\/p>\n

\u201cThe fact is that Montana doesn\u2019t have true competition among providers on a pricing level because we don’t have enough providers to create a nuanced pricing structure,\u201d Hensley said during the bill\u2019s hearing in the House.<\/p>\n

Hensley also said providing incentives to\u00a0patients to take the cheaper option would only give them lower quality care.<\/p>\n

Buttrey said the bill is still effective without the incentive.<\/p>\n

\u201cThere was never a requirement to force people to drive the extra miles,\u201d he\u00a0said. \u201cEven without the incentive \u2026 it\u2019s going to encourage competition.\u201d<\/p>\n

Buttrey said he not only wants to increase transparency, but to encourage competition among providers, which he believes will ultimately bring prices down.\u00a0He also said the bill would encourage uninsured patients to seek care by finding hospitals that provide it for less.<\/p>\n

\u201cWe have to lower the cost of care at the providers,\u201d Buttrey said. \u201cWithout competition, I don\u2019t really know how you\u2019d do that.\u201d<\/p>\n

Michael Siebert is a reporter with the UM Community News Service, a partnership of the University of Montana School of Journalism and the Montana Newspaper Association.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"

HELENA \u2014 With the future of health care on the federal level still unclear, Republican lawmakers in Helena are pushing legislation that could reshape how Montanans access and pay for medical services. Three bills\u2014House Bill 266\u00a0and Senate Bills 100 and 362\u2014are based on the premise\u00a0that individual states should be able to determine what health-care practices […]<\/p>\n","protected":false},"author":144,"featured_media":17181,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16,14],"tags":[5416,5756,5754,1122,5755,5376],"class_list":["post-17180","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-montana","category-news","tag-cary-smith","tag-ed-buttrey","tag-health-care","tag-montana-legislature","tag-montana-policy-institute","tag-nancy-ballance","prominence-category-featured"],"_links":{"self":[{"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/posts\/17180","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/users\/144"}],"replies":[{"embeddable":true,"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/comments?post=17180"}],"version-history":[{"count":2,"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/posts\/17180\/revisions"}],"predecessor-version":[{"id":17183,"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/posts\/17180\/revisions\/17183"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/media\/17181"}],"wp:attachment":[{"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/media?parent=17180"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/categories?post=17180"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/montana-mint.com\/lastbestnews\/wp-json\/wp\/v2\/tags?post=17180"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}