A Healthier Oklahoma - It Could Happen With the Right Reforms

The Sunday Oklahoman, Editorial

Health care analyst Grace-Marie Arnett is offering what's been labeled "a fresh approach" on health care reform. Her ideas are fundamental common sense in an area that often makes little sense. Arnett recently visited Oklahoma to speak before a legislative panel and to visit the editorial board of this newspaper.

The Oklahoman advocates deposit of tobacco settlement funds into a trust - with interest payments bolstering health care. Still, we hope that all new dollars for government-financed health care will be spent more wisely than in the past.

Oklahoma's poverty, relative to the rest of the country, makes problematic both government and private efforts to improve access to affordable health care. Arnett, who runs a public policy organization in suburban Washington, said past "reforms" have fed dubious outcomes: "For decades, state and federal legislators have created and expanded government entitlement programs and imposed more and more regulation on the health sector. Yet the number of uninsured continues to rise, reaching 44 million last year, according to the Census Bureau."

The General Accounting Office, she noted, has "studied the states that were most active in passing health insurance regulations affecting their individual and small group markets. These states mandated what insurance must cover, to whom and when it must be sold, and what the premiums could be."

Arnett said that the Galen Institute she runs, working with the Heritage Foundation, "looked at the experience in the early 1990s of 16 states that had been identified by GAO as having been most active in passing regulations. Unfortunately, the efforts backfired. Regulations to require insurers to sell policies at politically determined prices with mandated benefits and guaranteed access to insurance - even if people wait until they are sick to buy coverage - had the effect of driving up prices and driving health insurance out of reach for more and more of their citizens."

Obviously, "Legislators who design Cadillac plans when most people can afford only a Ford condemn their citizens to going without coverage at all. We found that the uninsured rates in the 16 states that were the most aggressive in passing health insurance regulations rose eight times faster than the other states the year after all the regulations went into effect." Good news: Oklahoma was not among the 16 states that moved so foolishly. Bad news: A strong constituency for such misguided action exists in the state Legislature.

Arnett has an essay in the January 2000 issue of Perspective, a publication of the Oklahoma Council of Public Affairs. A note accompanying Arnett's piece hailed Labor Commissioner Brenda Reneau Wynn for being "on target in wanting to use interest earnings to help Oklahoma's working poor obtain better health care services." Arnett's study "points the way," the council said, to practical policies supporting the commissioner's approach. State Treasurer Robert Butkin, Attorney General Drew Edmondson, Lt. Gov. Mary Fallin, Senate President Pro Tem Stratton Taylor, House Speaker Loyd Benson and other supporters of the trust fund could profitably mine Arnett's works for policy ideas to bulk up such ideas. This could positively impact availability of health care for those who are willing to work but whose resources are stretched by the cost of private insurance. This seems like an unusually good opportunity for diverse interests to work for a common policy goal.

Arnett said in all her work that real progress in helping the poor could come, among other things, through reforms aimed at creating our own version of the State Children's Health Insurance Program. This program works with private providers to bring benefits to the poor, using vouchers and other devices to make coverage accessible. Other reform ideas include tax credits for workers who purchase their own coverage - an idea supported by the White House and Congress - and market-oriented reforms in Medicaid.

Such sensible, market-driven approaches to resolving difficult questions of health care, insurance and access deserve serious consideration.

? The Oklahoma Publishing Co. and its subsidiary, Connect Oklahoma Inc.