Idaho's Medicaid budget is growing faster than the state's ability to pay for it.  Expensive administration and unhealthy lifestyles are amoung the problems, writes Janice McGeachin, as as Post Register Guest columnist.

Health care's Skyrocketing costs

In the July 7 editorial, Marty Trillhaase referred to the 11 members of the House Health and Welfare Committee as inexperienced.  As a member of that committee, I would like to share with readers my experience and my commitment to the challenge that we are facing with the skyrocketing costs of health care.    I am a small business owner who propvides health insurance to 35 employees.  For several years now, Idaho families, small businesses, school districts and state Medicaid programs have experienced double-digit increases in the cost of health care.  Last year alone, health insurance premiums for my employees and their families increased by 59 percent.  I have seen firsthand the devastating effect that these double-digit increases have on my business and my employees' pocketbooks.  No one — not the family, not the small business, not the school district and not the government — can sustain these levels of increases every year.  We must control the skyrocketing costs of health care to protect our state budget and to protect our economic recovery in Idaho.    In 1993, 25 percent of Idaho's Medicaid budget was for optional services not required by the federal government.    In 2003, 56 percent of Idaho's Medicical hudget was for optional services.  We cannot continue expand these optional services without implementing policies to curb the costs of health care.  As a member of the House Health and Welfare Committee, l support these policies to control the skyrocketing costs of health care:    ■ A health care system that measures and improve outcomes.  Various studies indicate that thousands of people die annually as a result of medical errors, hospital-acquired infections and medication errors.  In addition to the tragic loss of lives, there is a tremendous cost to the taxpayer for these mistakes.  The principle cause of error is not the individual care provider but a hopelessly flawed health care industry.  A key principle of any quality control program is data transparency.  Comprehensive data should be collected to implement a quality systems approach, providing a benchmark for improvements.  Our health care will continue to suffer until the induslry implements an outcomes-driven, data-transparent system that focuses on quality by uncovering errors, determining root causation and implementing a systemic solution to ensure the error is avoided in the future.    ■ Individual responsibility for making healthy life choices and caring for one's own health and well-being.  The health care industry is riot properly influence by market dynamics.  The individual must have an economic

interest in his or her own health, and is the primary guardian of how his or her money is spent.  Personal control of health care dollars can be promulgated through the expanded use of defined contribution plans for Medicaid patients and Health Reimbursement Accounts.  I voted to support the development of a consumer directed care model for individuals with disabilities, which will allow individuals to be more accountable for how their Medicaid dollars can be spent.  I was also responsible for implementing the Idaho Long-Term Care Partnership Plan, upon amendment to the Social Security Act, which will provide Idahoans an incentive to purchase their own long-term cure insurance.  This will help to curb the costs of long-term care, which is the third highest expenditure in the Medicaid budget.    It is time for us to recognize the impact that poor health is having on health care costs.  Major coat pressures today result from diseases that are, for the most part, consequences of unhealthy behavior.  Type II diabetes can be prevented, more often than not, by appropriate behavior and diet changes.  Since 1990, there has been a 33 percent increase in the number of people with diabetes in the United States.  In the past 20 years, adult obesity has increased 50 percent.  Obesity, poor diets and lack of physical activity are three of the major underlying causes of chronic health conditions, which translates into significantly higher health care costs.  Our health care system must do a better job of helping us understand our risks and change our behaviors.    ■ Health and Welfare programs that are administered with a minimum of bureaucracy and a goal of helping all recipients return to a self-sustaining and productive life.  Currently, Idaho's Medicaid administrative cost ratio is 8.1 percent, as compared to the national average of 4.8 percent.  For the past two years, I have been studying the budgets and the operations of the various programs to try to determine why Idaho's cost is so much higher than the national average.  If our Medicaid cost ratio were closer to the national average, $25 million in state and federal money could be saved.  I reject the practice of active recruitment of employed and employable people as welfare and Medicaid recipients.    We must transform current patterns of medicine, health and health care into a system that will empower individuals with the knowledge to take control of their health and, when necessary, their own health care.  The result will be healthier ldahoans and a less expensive health system.    McGeachin, R-Idaho Falls, is serving her first term in the Idaho House of Representatives.  You can write to her of 6121 N. Fifth West, Idaho Faits, ID 83401.