Roundhouse politics proving too sick to reform health care

For the last year, polls have reported consistently that health care is a priority for New Mexicans and their fellow citizens around the United States.

In fact, health care reform was important enough to merit a special legislative session last summer, resulting in a stalemate over Gov. Bill Richardson’s proposals. Everyone agrees that our over-priced, under-producing, and fragmented health care system is in need of serious attention.

Yet with about two weeks left in the 2009 legislative session at the Roundhouse, there has been no significant action toward reform.

Why?

First, a few basic principles about the state of health care in New Mexico. Our state shares the dubious distinction with Texas as having the highest percentage of uninsured residents — roughly one in four. Up to an additional quarter of the population is what is known as “underinsured,” meaning that their coverage is fragile, prone to lapses, or doesn’t adequately cover basic medical services — or a combination of these shortcomings all at the same time.

A recent survey shows that only six of 10 New Mexican workers are covered by employer-sponsored health care, the lowest percentage among all states.

So, the answer is simple, right? Just insure all of New Mexicans.

This is where political and ideological opinions differ greatly, making it difficult to achieve consensus needed for reform. The role of the insurance companies is at the center of the debate, with some advocating for the removal of for-profit private insurers as the foundation for health insurance.

Dr. Bruce Trigg, a pediatrician and chair of the Network of Health Professionals for a National Health Program, feels strongly that only a single-payer, Medicare-for-all approach is going to cover all citizens while containing costs. “We see what greed did in the stock market, but that same greed is at work every day in health care,” Trigg argues.

In this year’s legislative session, two major proposals to overhaul the health care system in our state have been presented: the Health Security Act and the Health Authority. Neither would eliminate insurance companies, but the proposals would and could, respectively, change the playing field with regard to health care insurance.

The Health Security Act, a product of the Health Security for New Mexicans Campaign, would allow New Mexico to set up a cooperative-style health plan covering 1.6 million of New Mexico’s 2 million residents (excluding those served by federal health care, such as those in the military), allowing private insurance to be sold only as supplemental coverage.

“Our bill has broad-based public support, including businesses and many cities and counties,” claims Dana Millen, the Education and Outreach Coordinator for the Campaign. “It is a paradigm shift that will get us to affordable, universal health care by putting all of us into one risk pool.”

Currently, the bill’s sponsor, Sen. Carlos Cisneros, a Questa Democrat, is waiting to bring it before Senate’s Finance Committee. It has already passed by a 5-3 margin in the Senate Public Affairs Committee.

In the past weeks, it had an unsuccessful run through the House where it attracted packed crowds for its committee hearings. The bill was tabled in the Business and Industry Committee.

Then there is the Health Care Authority Act, a bill that would create an independent authority of health care professionals, consumer advocates, business and policy experts who would be charged with coming up with a “comprehensive action plan for accessible and affordable health care for all people living in New Mexico.”

Roxane Spruce Bly of Health Action New Mexico, one of the organizations supporting this bill, feels that this bill works to limit the influence of the special interest groups financially invested in the status quo and allows time to think through the best plan for the state. This bill, sponsored by state Rep. Mimi Stewart, an Albuquerque Democrat, passed the Business and Industry Committee this past week by a vote of 11-0. It now waits to be considered by the House Appropriations and Finance Committee.

Gov. Richardson, meanwhile, has a health care agenda encompassed in 10 bills, one of which “seeks to move forward on decreasing the number of uninsured New Mexicans and addressing cost, quality and access issues,” according to a press release released Jan. 26 by the governor’s office outlining his health agenda for this year’s session.

“This package of health care reform legislation fits in this year’s agenda of creating jobs and balancing a tight budget. This is the right time to tackle these issues to help secure affordable health coverage and quality healthcare for all New Mexicans,” the Democratic governor is quoted as saying.

Lots of ideas, lots of talk, but again, why are we not seeing more urgency and at least something resembling badly needed reforms in this realm from Santa Fe?

Ask five legislators and you will get five different answers. Some are waiting from action at the federal level. Others are simply hesitant or resistant to make large changes in a system that they feel works pretty well, most of the time. And then there is the excuse of the year — bad timing — given the state’s severe budget woes.

Having spent much of the last weeks at the Roundhouse, it is clear to me that while this is a golden opportunity to enact the large-scale reform that is needed to heal a health care system currently on life support, too many factions and too little consensus among the coalitions and politicians involved mean the issue is unlikely to get anywhere, anytime soon.

Meanwhile, the Roundhouse chatter among heath care reform activists is that the Richardson administration seems intent on blocking all reform efforts not coming from within its ranks.

My prognosis: Until a more cooperative spirit takes hold, the uninsured and underinsured, along with the broken system that tries to support them, will hobble along, hoping to survive long enough to see meaningful health care reform come to be.

Anthony Fleg, a regular NMI contributor, is a family medicine resident physician at the University of New Mexico and a coordinator for the Native Health Initiative.