How Low Can You Go?

The state of Florida recently passed a health reform bill that would reduce the number of uninsured in the state by offering a "no frills" state health insurance product for as low as $150 a month.  Insurers participating in the program would be required to provide coverage for annual physician visits, inpatient hospital stays, mammograms, prostate screenings, immunizations, emergency department visits, and prescription drugs. Specialist care and long-term hospitalizations would not have to be covered. The product would also be exempt from the mandatory benefits of other health insurance products sold in Florida. 

Oregon has experimented with the idea of limiting benefits in its Medicaid program, yet faced opposition from the federal government. The state currently has a Prioritized List of Health Services developed by a public commission for the Oregon Health Plan. Florida's plan is not administered through Medicaid; it does not get federal funding and does not require federal approval. 

The Oregon Health Fund Board Benefits Committee is currently considering recommendations to the Board to create an "Essential Benefits Package" that instead of covering all health services would prioritize evidence-based medicine that keeps people heathy.  Health services identified as higher priority would be provided at little or no cost to the patient, while lower priority services would have higher co-payments or not be covered.

Is limiting services the answer for expanding health coverage?  How can the maximum number of people be covered without breaking the state's bank?

Comments

[jen]

Cost containment is vital. Medical marijuana can reduce medical costs for many patients by reducing the amount of time spent in hospital, the number of doctor visits, the number of medications the patients takes as well as reducing the likelyhood of drug interactions, and the number of ER visits annually.

[Anne-Lise Schulz, nursing student]

While I want to believe that health care prevention, in the long run, would reduce medical costs, according to an article in the Washington Post on 4/8/08, "one reason why prevention efforts do not save money is that they target many more people than will ever come down with the disease being prevented." It further states that giving information for prevention is expensive. For example, there was a study done in Australia that claims that giving videos and books to women who are at low risk for heart disease and their doctors cost $9.8 million "for every year of life saved in the prevention of premature heart attack deaths."

I don't know about you but I find that pretty inexpensive when it comes to saving a life. So, I guess I am still a believer in spite of the studies.

Thanks for listening