RX for Change: Confronting the health care crisis in Kansas

Dec. 8, 2005

By MIKE CORN

Hays Daily News

From a legislative perspective, health care in Kansas is about improving access and affordability.

Progress has been made on access, said Rep. Jerry Moran, R-Kan., but plenty of work remains regarding affordability.

Health care is a top concern of constituents Moran meets during his travels in the First District. As a result, it is also at the top of Moran's list, along with agriculture.

Health care also is a priority for Sen. Pat Roberts, R-Kan., though his attention to the issue has been diverted by a multitude of issues facing the Senate Intelligence Committee, which Roberts chairs.

Both Moran and Roberts are keenly aware of the need for Critical Access Hospitals, those that dot smaller communities in Kansas.

“I have personally spoken with Secretary of Health and Human Services Mike Leavitt,” Roberts said, “and have expressed my strong support for strengthening our hospitals and providing appropriate regulatory relief from burdensome and complex regulations.

“Next year, the Senate Rural Health Caucus ... plans to introduce a comprehensive rural health package that will address many of the concerns our small hospitals are experiencing.”

Moran said his district has the highest number of critical access hospitals — 75 — of any district in the nation. And many of those hospitals are heavily dependent on Medicare reimbursements because of the high percentage of patients — in some cases as high as 90 percent — who are eligible for Medicare.

“Health care certainly is a significant issue,” Moran said.

And to Moran's way of thinking, health care should rank even higher than Social Security reform.

“But how do you get this on the national agenda?” he asked.

Roberts believes steps have been taken to do just that.

“There are clearly issues in today's health system that need to be fixed,” he said. “First and foremost, we see too many people that are unable to get health insurance or that refuse to because of the cost.”

In February, Roberts said, the Senate Health, Education, Labor and Pensions Committee passed legislation that provides money for state high-risk pools that provide access to health insurance to people who are not covered under an employer plan or a government program.

Kansas, Roberts said, is among 30 states with a high risk pool. The Senate measure is awaiting House approval.

Roberts also supports increased spending for nursing and health professions programs.

“These programs are vital in Kansas and play a crucial role in our health system by providing workforce development and education for our providers,” Roberts said. “In addition, these programs allow our underserved areas, such as the many rural communities that dot western Kansas, access to health care providers.”

Moran is a believer in improving the quality and capability of health care technology, in terms of allowing information sharing.

For example, Moran suffered from kidney stones and had the same tests performed three times at different locations because the information could not be shared.

“Why can't the CAT scan that takes place on Wednesday in Abilene work in Hays on Friday?” Moran asked. “Well, because they don't have the record. Because we don't have the technology in place.

“Technology has done huge things in so many areas of our economy, and we have great technological leaps in health delivery but not in the management or recordkeeping system of our health-care delivery system. It's still antiquated.”

Moran also supports tort reform to stem the tide of lawsuits filed when bad outcomes occur.

He is concerned about doctors practicing defensive medicine, which costs billions of dollars, he said, to “perform tests that show they have done everything so that they don't get sued or if they get sued show they've got the defense.”

And, Moran said, he thinks the nation has under-utilized preventive medicine.

“I think the biggest bang for our buck in reducing the cost of health care is for people to live more healthy lives.”

He is not an advocate of dictating such behavior, but supports using educational and promotional methods as well as full reimbursement of preventative measures.

He pointed to mammograms as an example.

“It is much less expensive, in addition to saving lives, to treat somebody before the cancer develops. So we could save a lot of money by reimbursing for preventive medicine.”

But prescription drugs are, perhaps, most troublesome for Moran. That is due, in part, to the prescription drug program that goes into effect next year for people covered by Medicare.

Moran voted against the bill that allowed the prescription drug program because he was opposed to facets of the program.

“It has a lot of flaws,” he said, “including the fact that we have prohibited the federal government from negotiating with drug companies for a lower price. The reason you would have a prescription drug benefit is to get quantity buying, passing the savings on to the consumer.”

Moran is a proponent of generic drugs, and said reimbursement rates should encourage their use. And he's ready to look at the patent process for drugs.

He supports importation of drugs from Canada through local pharmacists, saying it creates competition.

“Drug companies spend more money on advertising than they do on research,” he said, admitting that Congress likely cannot take away that right to advertise.

But, he said, it could pass legislation that might provide a disincentive for advertising.

“My greatest concern about the prescription plan is that the drug companies will advertise even more and convince every senior they need that yellow pill, utilization will go up, and we will bankrupt the Medicare system.”

Moran favors a prescription program, but he thinks it should be targeted to people who cannot afford the drugs prescribed for them.

“My belief is that that prescription drugs are important and we should start with those people who could not otherwise afford the drug as compared to every senior. At least initially, let's see how we make this work and how we afford it and how we pay for it.”

Moran said he has introduced legislation to let Health and Human Services negotiate with pharmaceutical companies for lower prices.

It will, he said, pass one day.

“I think it will ... because the cost of prescription drugs will overwhelm the system.”

Absent that, the federal government will look at raising taxes that support Medicare, or “we could do something smarter,” Moran said.

“... Reduce the cost, the money that we're paying out for prescription drugs.”