Kevin Lays Out Agenda for State-Based Health Reform

COLUMBUS, OH – State Senator Kevin Coughlin (R-Cuyahoga Falls) today sent the following memorandum to his Republican colleagues in the Ohio Senate. Coughlin is chairman of the Senate Health, Human Services, & Aging Committee:

As the debate over health care reform reaches a fevered pitch in Washington, I think it is appropriate for our caucus to put forward a state-based approach to lower health care costs and open up greater access.

We’ve made some progress here already with dramatic medical malpractice tort reform. But the current federal proposal would eventually squeeze out private health coverage and quality care, replacing it with government-run coverage and mediocre care.

Given our majority in the Senate, we have an opportunity to provide other states with a template for resistance to a federal takeover of health coverage and define a proactive approach to lowering costs and creating access. I suggest the following:

Pass Senate Joint Resolution 2

Universal health care is a goal shared by people from both parties. But states can define the context of that reform by taking a strong stand against an individual mandate and government-run health care.

Early this year while the health care debate was still simmering I introduced SJR 2, a proposed constitutional amendment protecting the right to enter into private contracts with health care providers for health care services and to purchase private health care coverage. It also prohibits the General Assembly from requiring any person to participate in any health care system or plan, or to impose a penalty or fine, of any type, for choosing to obtain or decline health care coverage or for participation in any particular health care system or plan.

This addition to our state constitution will be a clear expression by the people of Ohio that we do not want compulsory government-run health care. It is possible that health care reform may provide the opportunity for the long-awaited showdown over states rights in the United States Supreme Court. If that comes to pass, states can help support that case now by passing measures similar to SJR 2.

It should be noted that SJR 2′s proposed election date for the issue to appear on the ballot will have to be amended to 2010.

Urge Congress to Remove the Handcuffs

We should pass resolutions urging Congress to provide the two most meaningful reforms they can: tax equality and interstate pooling of risk. Congress must address the disparity in tax treatment between those who have health care provided by an employer and those who purchase it themselves. And Congress would do well by states by allowing privately-insured people to enter multi-state risk pools. Currently, people are restricted to in-state only insurance. Multi-state private insurance dilutes risk, creates greater stability, and keeps costs under control.

Explore Multi-State Partnerships

We should explore the legality and feasibility of entering into a multi-state compact for the provision of multi-state private health insurance. Compacts have allowed states to innovate while asserting their sovereignty. We should pass legislation directing the state to work with the Council of State Government’s Center for Interstate Compacts to explore this possibility.

Address Wellness and Prevention

Healthy people cost less. While much can be done without legislation, I would urge all members to think about ways the legislature can combat preventable chronic diseases, reduce childhood obesity, and help local governments with healthy design.

Senator Eric Kearney and I are set to introduce a bill addressing childhood obesity and school nutrition and activity. This is a collaborative effort with the Ohio Business Roundtable and I urge you to take a look at the bill and give it your support.

A renewed commitment to smoking cessation and prevention, and consideration of reasonable diabetes and colorectal cancer screening insurance coverage should also be part of our agenda. While none of these appear to fit in our conservative world view, the data linking prevention in these areas, costs savings, and reduced deaths is compelling and impossible to dispute.

Collaboration with the Private Insurers

We should seize the initiative and engage the health insurance and health care stakeholders to develop a low-cost bare bones product that anyone not eligible for Medicaid can afford. Remember that the private health insurance market is primarily regulated by the states, not by the federal government. Our ability to change the private market in Ohio, preferably by consensus, is important in showing that states are the rightful place for this reform. This type of leadership will not come from the governor.

One Stop Shop for Health Care Consumerism

Advanced consumerism in health care will lead to better quality and lower costs as providers compete for patients. The state should be taking steps to allow Ohioans to become better, more empowered consumers of health care. That means providing information to help them choose providers.

We should pass legislation establishing a one stop shop website providing information on quality, cost, and efficiency so people can make informed decisions when choosing providers. The state already collects a host of data including but not limited to hospital infection rates, disciplinary action, violations, and much more. We should also collect information on the costs of procedures and services and their outcomes. Ohioans should have the opportunity to share their reviews of providers on the website making it a “TripAdvisor.com of health care.”

There is much more that Ohio and other states can do. But within the remaining timeframe of our session and with Congress moving quickly on federal reform, I urge Senate Republicans to show the nation why states are the right place to address critical health care issues.