Friday, January 3, 2020

State Actions to Reduce Healthcare Costs

The State of Tennessee is attempting to expand access to care for more people.  Medicaid expansion or a single-payer system and other subsidies will increase demand for healthcare when people perceive it as a "free" service.  Meanwhile, regulations and laws restrict the ability of the market to supply that increased demand.  The result will always be increased prices.  To control costs, governments will be forced to ration care, as all government-run healthcare system do.

Therefore, rather than increasing prices, allowing the supply of medical care to grow will have the opposite effect, allowing for more access to healthcare for more people.


In order to achieve this goal, Tennessee can enact five reforms which are demonstrated to reduce costs and increase access to healthcare.


1.     Expand telemedicine to embrace technology and innovation which are leading the way towards drastically reducing patients costs while increasing patient access—particularly for those who are low-income or living in rural areas.

Compelling evidence shows that telemedicine does work for a wide range of conditions if the process is structured in a smart way. And the health care system will only get better at utilizing telemedicine. Better software platforms to manage telemedicine and changes to the patient interaction process, e.g. making it more asynchronous, promise improvements. Entrepreneurs and startups are leading the way here.

Second, the economics of telemedicine are compelling for providers. Telemedicine visits tend to be shorter than office visits, so provider time is used more effectively. The overhead required to support telemedicine visits is also less: office space, receptionists, and data collection time. From my work with a primary care provider organization, I’m convinced that about half of primary care visits can be accomplished by telemedicine at about 2x the productivity of office visits. This can go a long way to alleviate the shortage of primary care providers and help hold down the cost of medical care.[i]

2.     Reduce existing state-level mandates so that Tennessee insurers can begin offering plans that give patients more affordable and customized options that fit their individual needs.

While a single health benefit mandate may only increase premium rates between $50 and $700 dollars annually per employee depending on the plan type and coverage, the accumulation of multiple health benefit mandates can result in a significant increase in the cost of health insurance benefits for small business employers and employees. Even at the lowest annual increase of $50, 20 mandates will result in an increase in premium costs of at least $1,000 annually.[ii]

3.     Authorize Health Savings Accounts (HSAs) within the TennCare program. In doing so, we provide those low-income Tennesseans with more options to make cost-conscious and individualized decisions that improve their financial and healthcare outcomes, while also addressing concerns over ballooning state costs. 

4.      Eliminate Certificate of Need (CON) laws

      Tennessee, in detail:  https://www.mercatus.org/system/files/tennessee_state_profile.pdf

The weight of evidence suggests that a full repeal of CON laws would expand access to healthcare in Tennessee that is of both high quality and low cost.

Given the substantial evidence that CON laws do not achieve their stated goals, one may wonder why these laws continue to exist in so much of the country. The explanation seems to lie in the special-interest theory of regulation. Specifically, CON laws perform a valuable function for incumbent providers of healthcare services by limiting their exposure to new competition. Indeed, recent evidence suggests that special interest groups are able to use political donations to increase the odds that their CON requests will be granted. This aspect of CON laws helps explain why economists as well as antitrust authorities have long argued that these regulations are anti-competitive and harmful to consumers.[iii]

5.      Eliminate professional licensing in medicine and leave education, credentialing, and scope-of-practice decisions entirely to the private sector and the courts.

Medical licensure fails to meet expectations in the area of discipline and consumer protection. State medical boards’ disciplinary efforts can arguably be said to protect clinicians more than consumers. Many actions against clinicians are settled privately and after extended periods of time. Clinicians who have faced disciplinary actions often continue to practice, with no public disclosure of the reasons for the sanction. The persistent difference between the promise of licensing and its actual performance is summarized by one long-time observer of New York’s licensing laws, who describes that state’s statutory authority as “exemplary” but the state’s use of that authority “shameful.”[iv]



[i] Hixon, Todd. “Will Telemedicine Change Healthcare Or Prove To Be Another Venture Fad?” Forbes, 10 June 2016, www.forbes.com/sites/toddhixon/2016/06/10/will-telemedicine-change-healthcare-or-prove-to-be-another-venture-fad/#418129744248.
[ii] COST OF STATE AND FEDERALLY MANDATED HEALTH BENEFITS
Report to the Tennessee General Assembly. Prepared by the Fiscal Review Committee Staff, June 29, 2011
[iii] Mitchell, Matthew D. Tennessee's Certificate-of-Need Program: Lessons from Research. Mercatus Center - George Mason University, 31 Oct. 2019, www.mercatus.org/system/files/mitchell_-_testimony_-_testimony_on_tennessees_certificate_of_need_program_-_v1.pdf.
[iv] Svorny, S. (2008, September 17). Medical Licensing: An Obstacle to Affordable, Quality Care. Retrieved January 3, 2020, from https://www.cato.org/sites/cato.org/files/pubs/pdf/pa-621.pdf.

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