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January 11, 2006

Health Care in WV

West Virginia's governor Joe Manchin just gave his State of the State address, which came complete with a bevy of serious, thoughtful, expansive health initiatives. For those who follow this stuff, the relevant excerpts follow after the jump. More analysis from me tomorrow and in coming days, as it is, I just got back from the gym and need a shower. But pay special attention to his first proposal: the preventive care clinic-based plan. Sexy as the name is, it's a return to the days of straight insurance, and a departure from the currently dominant managed care mazes. Anyway, more to come, as some articles I'm working on are going to demand a lot of ongoing attention to state-based health initiatives.

"My second major legislative initiative revolves around healthcare. Every working person in West Virginia deserves access to basic, affordable healthcare, which is why I am so committed to keeping the good jobs with healthcare benefits that we already have in this state and am looking for ways to create many, many more. While we are making progress in those efforts, we must not forget those West Virginians who work one and even two jobs, but still can't afford healthcare.

We have done a better job in our state of covering our children, our elderly, our less fortunate, and even our prisoners, but we have a long way to go for those adults who get up every day, go to work, and pay taxes to move this state forward, yet have no health coverage.

This is just wrong.

However, we have made some important strides during the past year with the initiation of two new programs: The West Virginia Small Business Plan and Access West Virginia. In June, the West Virginia Small Business Plan was introduced to provide small business owners and employees across our state with an affordable healthcare coverage plan. Then, in July, we introduced Access West Virginia - an innovative insurance solution for individuals who have faced chronic and often serious illnesses. But it's still not enough.

A majority of West Virginians who are uninsured work full time. They may work two or three part time jobs and are simply not eligible for these company's insurance plans. Or, they may work for one of West Virginia's many small businesses that cannot yet afford to provide health insurance for its employees. These individuals cannot bear the cost of a high premium every month and need affordable alternatives that will meet their basic needs without breaking the bank. And they are not alone in their plight - the cost of healthcare to individuals and states has increased throughout our nation to the point that it is now affecting peoples' ability to pay their every day bills and making their lives much harder.

And so, tonight I am proposing two new public/private health initiatives to help these West Virginians get the affordable healthcare they need.

The first is a pilot project that will provide doctor visits, basic testing and reduced prices on prescriptions at a very affordable price. The "Preventive Care Clinic-Based Plan'' will set up sites around the state at primary care clinics or private doctors offices. Up to eight providers can participate, and have up to three sites each. The program will allow subscribers access to primary care services such as checkups, sick visits, x-rays and lab tests at the participating clinic or doctors office for one monthly fee. This is not insurance and does not cover specialists or hospital costs, but it does provide basic preventive care at a very low price - starting at some clinics for as low as $1 a day.

The second proposal is called the Affordable Insurance Initiative. This effort provides for affordable insurance plans for individuals who want, and can afford, more in-depth coverage than the Clinic-Based plan. While it is not the Cadillac of healthcare programs, it is a form of meaningful, and portable, insurance that will provide the crucial primary and preventive services individuals and families need to meet the majority of their healthcare concerns. Once approved by the Legislature, this plan will be offered by commercial insurance carriers starting at a low cost of $99 per month.

Both of these new healthcare initiatives are affordable, cost effective and require no state subsidies. Make no mistake - these are bold steps. They serve as an example of how government and the private sector can work together to provide basic health services to the vast majority of West Virginians without health coverage.

Put the Preventive Care and Affordable Insurance plans together, and I believe we will be taking one of the most important actions towards improving the health and well being of our state's citizens and workforce for many years to come and setting a new standard for the rest of the country to follow. The sooner we can provide preventive care to our workers, the better off we all will be and the more lives we can save.

As for our other healthcare related efforts in the coming year, we have not achieved results as quickly as we all would have liked when it comes to reducing the cost of prescription drugs. Therefore, as part of a comprehensive purchasing overhaul package, I will introduce legislation to allow state agencies to enter into multi-state purchasing contracts, which could result in a savings of at least 20 percent on their pharmaceutical purchases - significantly reducing the cost of these needed medications for thousands of West Virginians.

And, as a follow up to an initiative that was started during last year's State of the State address, we will form, through legislation, a statewide Health Information Network. With this network, West Virginia will become a national leader in the conversion to electronic health records - which it is predicted will result in an increase in healthcare quality and the type of dramatic cost savings that can significantly impact the state's budget. In addition, as part of this overall electronic medical records initiative, the state will also coordinate with HEALTHeWV, an electronic medical records program supported by Senator Robert C. Byrd and managed by the National Technology Transfer Center at Wheeling Jesuit University.

I am also committed to working with hospitals and providers on achieving some form of an integrated medical billing system in West Virginia. It makes no sense to me that when you have a medical procedure performed at a hospital or clinic, they can't tell you upfront what it's going to cost. Then after the procedure is performed, you don't receive a complete bill and, if you're like me, you have no idea what the total cost was. This is the only service that I know of in America that operates under these billing procedures. Now is the time for us to change this process.

As for the state employee insurance system, PEIA, my administration is working with national experts on developing a plan to retool the entire program and make it more cost efficient for our current workers, retirees and taxpayers.

You have also heard me say many times recently that I want to build off of the work that was done last year to stop the spread of obesity, heart disease and Type II diabetes in our state's children. If I could end all of these problems right now with a new law or directive, I would - and I know you would too. But realistically, it's just not that simple. So I plan to join forces with the Healthy Lifestyles Council that this Legislature created last year and, with the help of a newly received Benedum Foundation grant, reach out to as many schools, children and parents as possible in an educational effort focused on giving them the information they need to make healthy choices.

As has been proven time and time again, if we can impact the habits of our youth, we as adults will soon follow. And make no mistake; my administration will continue to be committed to keeping the Five Promises to all of our children. "

January 11, 2006 | Permalink

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Comments

Good post and great ideas from WV's governor. Governor Manchin said "I am so committed to keeping the good jobs with healthcare benefits that we already have in this state and am looking for ways to create many, many more." You have to wonder though if he is successful with his healthcare programs, and I certainly hope he is, whether new businesses coming into the state will have any incentive to offer a health care benefit. I also wonder if some small businesses already in the state will want to drop the health insurance for their employees and instead, offer them an extra $100 so the employees can sign up for the state plan. This would also let Wal-Mart off the hook. In any event, this activity should be very interesting to watch. Best of luck to Gov Manchin.

Posted by: MarvyT | Jan 11, 2006 11:26:24 PM

I'll be interested to see more analysis from you on this Ezra. Sounds like some really good ideas to me.

In many ways, I would be much more supportive of universal health care plans after they had been tested in individual states. The urge to go directly to a national solution worries me because if unintended consuquences prove too damaging it could be very difficult to correct, while problems in a single state would effect the nation much less and be easier to change.

Posted by: Dave Justus | Jan 12, 2006 12:27:06 PM

I agree with Dave, state programs like Manchin will be easier to refine than a national plan. There is also the benefit of having well-run state plans to point to as good examples.

In terms of business, enacting Manchin's plan would benefit West Virginia in a couple of ways. First, it would help to create a healthier, more stable workforce, even for jobs at the lower end of the economic spectrum. Increased productivity is a great way to generate economic growth. Small businesses will be able to better compete with large companies in attracting the best workers, since people will have less non-job-related incentives to go with a large corporation over a small business. Those large corporations that are having a hard time with rising insurance premiums for their workers - that is, all of them - will start to see West Virginia as a good place to locate headquarters facilities and factories. In the short term, giving employees $100/month and telling them to go on the state plan might be selfish, but in the long term the more people on the plan, the more benefits can be added and the cheaper it can be.

The biggest obstacle, as always, is those people who automatically view government involvement in anything other than the bedroom to be bad, and who want to punish poor people for being poor. The sooner we can marginlize them and their stupid ideas, the better off this country will be.

Posted by: Stephen | Jan 12, 2006 12:42:04 PM

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Posted by: judy | Sep 29, 2007 11:28:31 AM

There will be an election day out there in the future, and I don't think the PEIA retirees will forget what has happened to them. The motto seems to be: "Do he before he do thee." I have heard so many retirees say they will remember this mess when it comes time to go to the polls. One retiree recently said she has relatives and friends who will remember what has been forced upon the PEPA retirees. If all retirees remind their relatives and all their friends of this CHANGE many votes will be cast ........... A J Manchin was a people's man ... shame that his nephew is not.

Posted by: Maxine Faye Cottrell | Nov 9, 2007 3:39:22 PM

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