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Show HEALTH CARE REFORM IN UTAH: AN ANALYSIS OF LEGISLATIVE AND PRIVATE PROPOSALS by Bryant Howe, MPA Introduction Early Legislative Studies For the past fifteen years, as part of its regular interim study process, the Utah Legislature has examined a variety of health care reform issues. Generally, these studies have resulted in little action. However, some of the major developments in Utah health care policy, such as the establishment of the Pro-Competitive Certificate of Need Act, Rural Physician Loan Repayment Act, Health Insurance Pool for the Uninsurable, and the Health Data Committee, began with gubernatorial and legislative studies. After lengthy and serious discussions with many interest groups, compromises were reached, eventually allowing these reforms. Early in his administration, Governor Bangerter appointed task forces to address financial barriers to health care, health care costs, and catastrophic medical expenses. In March 1988, the Governor's Task Force on Catastrophic Medical Expenses recommended that the state form a risk pool for persons who were uninsurable. This led to the formation of a legislative risk pool task force that recommended legislation establishing the Utah Health Insurance Pool beginning in 1991. In September 1988, the Governor's Task Force on Health Care Costs recommended that the state establish a Health Data Authority. During its 1990 session, the Legislature created the Health Data Committee to provide valid and accessible health care data to health care consumers. The private sector in Utah has also recently undertaken two health care reform studies. One private study by the Utah Health Care Access Steering Committee has been the basis for much of the action taken by the current Access to Health Care Task Force. Utah is fortunate to have health care experts working in private and educational institutions who are willing to donate their time and resources to advance the health care debate. This small core of experts also actively works to educate and persuade Utah's policy makers regarding needed changes in our health care system. The purpose of this article is to review and explain recent legislative and private sector health care reform studies in Utah. Legislation considered during the 1992 General Session of the Legislature and two reports by private sector committees will be summarized and compared. Finally, a brief analysis of how these various proposals answer some fundamental health policy questions will be presented. Legislative Activity Recent Legislative Studies The current efforts of the Utah Legislature to address comprehensive health care reform began in July, 1989, when a delegation of legislators attended the Annual Meeting of the National Conference of State Legislatures in Tulsa, Oklahoma. The keynote speaker at the meeting's opening session was Senator John Kistzhaber, MD, President of the Oregon State Senate and sponsor of the now famous Medicaid "rationing" plan. The Oregon Legislature had just established the Oregon Health Services Commission to rank and price various medical conditions. Impressed by what the Oregon Legislature was doing, especially with its "rational" approach to rationing health care, Representative Joe Moody and Representative Lloyd Frandsen decided to form a legislative task force in Utah to study the access to health care issue. During the 1990 session of the Legislature, Representative Moody introduced HB 29, creating the Health Care Insurance Task Force composed of Legislators, state agency officials, providers, and others to find ways of Utah's Health: An Annual Review 1993 103 |
