My extended family is fortunate. All of its members have quality health care at a reasonable cost, with very low copays and no deductibles. None of them can ever be bankrupted by medical bills. I am the exception. That is because they all live in Belgium, where I was born and grew up.
I am glad to be a U.S. citizen and have lived in Sierra County for more than 20 years, but, like many people, I work to stay healthy and out of doctors’ offices, since my insurance has high deductibles and copays so that I can afford the premiums. The U.S. health care system costs twice that of any other advanced country, while our health outcomes are near the bottom of the chart. I know we can do better.
Our system is neither healthy nor caring. Preventive medicine cannot be practiced when patients cannot afford to access it or pay for their medications. This undermines the general health of the population, especially the disadvantaged, and increases costs for everyone. High drug prices, excessive CEO salaries, stock buybacks and shareholder dividends that are driving up the cost of health care need to be controlled or eliminated from the delivery system.
Help is on the way! The New Mexico Health Security Plan, which calls for the state to set up its own program to provide health care coverage for most New Mexicans, has been worked on by a diverse group of stakeholders for more than 20 years. To move this game-changing plan forward, the Health Security Planning and Design Board Act will be introduced in the 2021 legislative session.
The Health Security Plan will offer enrollees the comprehensive benefits enjoyed by state employees, including mental health care, freedom of choice of health care provider (no more networks), and protection for those with preexisting conditions. The HSP will cover most New Mexicans, but federal employees and those in the military will retain their current coverage. In addition, Native American tribes and large, self-insured employers will have the option to join the HSP. Seniors will not lose any of the benefits or rights they have under Medicare.
HSP will operate like a cooperative. It will be directed by a 15-member citizens commission that is geographically representative and publicly accountable. Coverage will be paid for by existing public dollars (such as Medicaid), sliding-scale premiums (with caps) and employer contributions. If you lose your job or change jobs, your health coverage stays with you.
What other advantages are built into the HSP? Bulk purchasing of drugs will lower the cost of prescriptions. Global budgeting, which provides a fixed amount of funding for a fixed period of time for a specified population, rather than fixed rates for individual services or cases, will help to stabilize the finances of hospitals and clinics. This will be a particular boon to rural communities.
Businesses will experience reduced administrative costs by eliminating the need to purchase, manage and monitor complicated private insurance. The HSP will also help to attract and retain skilled workers in our state, as quality health care will be a reality for all New Mexico residents. In addition, workers compensation and automobile insurance premiums will be reduced for HSP members, including employers, since the plan would cover medical care for injuries resulting from workplace events or auto accidents.
HSP measures such as bulk purchasing of drugs and grouping most state residents in one health coverage pool will also lower administrative costs for health care providers, as well as for HSP itself.
Three separate studies, including one completed for the legislature in 2020 by independent analyst KNG Health Consulting, have shown that the Health Security Plan will slow rising health care costs. KNG estimated savings of $1.6 billion to $2.7 billion in the first five years of HSP’s operation, compared to what will be spent during that period on health care in New Mexico if we continue with the current system.
We can endure more years of rapidly rising drug prices, ever-increasing out-of-pocket costs, financially struggling hospitals, health care providers frustrated by endless paperwork, employers straining to find affordable health benefits for their employees, and even insured patients finding themselves unable to pay inflated hospital bills.
Or, we can invest in the Health Security Plan, a path toward real health security for Sierra County residents and all New Mexicans.
If you would like to know more about this solution and how you can support its enactment, visit nmhealthsecurity.org.
If you have a personal story about how the current health care system has not worked for you, the New Mexico Health Stories Project would like to hear from you. The project collects stories of New Mexicans who have struggled with the current health care system and makes them available on its website, Facebook page and other social media to illuminate how the HSP will make a difference in real lives. Sharing stories can influence others, build empathy, inspire action and transform opinions.
Thank you for caring, and stay healthy.
UPDATE: The Health Security Planning and Design Board Act was introduced on Jan. 28 as HB203. It has two House committee referrals: Health and Human Services, and Appropriation.