Why health care reform is so hard, NC edition

Well, first of all credit to our Republican NC Treasurer, Dale Folwell for trying to hold down ever-rising health care costs in the state by placing limits on what the State health insurance plan (what I’m on) will pay out.  In this case, 177% of Medicare reimbursement rates.  Even 177% of Medicare is less than hospitals and providers typically get from private insurance and they are not happy.  So, we get to see a perfect demonstration of where the real power in the health care debate lies.  From the N&O:

A plan to save state employees money on their health insurance expenses is facing opposition at the General Assembly over fears it could harm hospitals all around North Carolina, particularly in rural areas.

A bipartisan group of legislators are backing a bill that would stop changes to the State Health Plan that are set to start on Jan. 1, 2020. But if the bill becomes law it would put off the changes until at least 2022, if not permanently.

Robert Broome, the executive director of the State Employees Association of North Carolina, said his group “strongly opposes this bill, which is a clear attempt to put corporate interests over working families and deny taxpayers a cost savings of more than $300 million each year.”

At stake is a question over how hospitals and other health care providers are paid whenever one of the more than 700,000 people on the State Health Plan go in for medical care. Those include state employees, teachers, retirees and their families.

State Treasurer Dale Folwell, a Republican who won the 2016 election for that office, has backed reforms.

His plan, which is now being challenged by this bill, would create a system in which hospitals are paid 177 percent — or nearly double — of what they would’ve earned if the person had been on Medicare instead of the State Health Plan…

Folwell says his changes would save state employees and other members of the health planmore than $60 million a year in out-of-pocket costs, in addition to saving state taxpayers more than $300 million a year.

On Thursday he slammed the bill that would undo that cost-savings plan.

“As keepers of the public purse, we don’t have millions of dollars to spend on advertising and lobbying,” Folwell said in a written statement. “What we offer is devotion to good government and a promise to the people that we will do everything in our power to attack the problem and make health care more affordable and transparent for public employees.”

But hospital leaders say Medicare rates are too low for the plan to work, and that Folwell’s changes could be the final blow forcing some struggling hospitals in rural areas to shut down for good. [emphasis mine]

To be fair, I don’t know the financial situation of NC’s rural hospitals, but I don’t think the State health insurance plan over-paying for everything is the solution.  And it is not at all dissimilar from the corporate claims you get that every single new tax increase or new regulation will bring economic disaster.  And who doesn’t like rural hospitals?  It’s almost like the puppies of the health care debate.  Give us more money, or the puppies get it!

Anyway, lots more stuff in the article, and I’m pretty curious to see what happens here (okay, the hospitals will win), but this is a great example why meaningful health care reform is so hard.  Some people will make less money and they really, really don’t like that.

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