Patients' plight highlights flawed health care approach

The Olympian's editorial "State must do better on Medicaid" did a good job of highlighting the problems nursing homes face caring for Medicaid patients. Low reimbursement rates from the state create a disincentive for nursing homes to dedicate beds to Medicaid patients and make it difficult to maintain a high level of care.

Lawmakers are aware of the problem, which was one of the major challenges that led to the formation of the governor's Blue Ribbon Commission on Health Care Costs and Access. There is bipartisan support to increase funding for these Medicaid patients.

This problem is not just about nursing homes. Resources are spread thin for all health care providers that serve low-income Medicaid patients. The state has failed to get control of escalating costs and, until it does, we will be back each year trying to squeeze more out of the state budget for Medicaid - and most likely coming up short.

The most important and comprehensive task for lawmakers is to solve the structural problem that underlies all government-

purchased health care. The current approach has led to runaway costs, limited access and a lack of funding.

As health care becomes more expensive, some say we need to enroll additional people into government-run health care programs. I have also heard it said that the definition of insanity is continuing to operate in the same manner and expecting a different result.

To continue along the same path would be to ignore the flaws in the current approach and deepen the existing crisis - but on a larger scale. We cannot afford this scenario. Before we consider this option and strain limited resources even further, the state should focus on doing a better job of delivering services to the people already under its care.

One solution is to reduce costs and create plans that families and employers can afford. Years of government regulatory changes have created distortions in the way health care is purchased, developed and delivered. This has led to more costs and a rigid system.

Another solution is putting consumers back in charge of their own decisions. Whether it is government-run health care or private managed-care plans, patients - and to some degree care providers - have been cut out of the deal. Giving them a stronger say would create incentives for better health care decision-making. It would also help control costs and empower consumers.

Government needs to lay down the foundation of a system that provides patients with good information and flexibility to respond to their needs. With control over their own health care dollars and information to make decisions about their care, there will be a transformation in the way health care services are delivered. It will become more accountable, convenient, efficient and affordable.

In discussions of the Blue Ribbon Commission, I sense lawmakers understand these principles. There is broad-based support to advance meaningful, bipartisan reforms in the 2007 legislative session.

If we fail, we will continue to face challenges such as expanded dependency on government, limited access and choices, and higher costs for taxpayers and patients.

Rep. Bill Hinkle is the ranking Republican on the House Health Care Committee and a member of the governor's Blue Ribbon Commission on Health Care. He represents the Cle Elum area and is a former emergency medical technician.