Friday, November 6, 2009

Cody, Morrell and Moeller prove information saves us money - lots of money

Technology is improving health care in many ways, but it comes at a cost and not all health care technologies are doing a good job of delivering on their promise to make us healthier.

Washington state provides nearly $3 billion worth of health benefits every year to public employees, people on workers' comp, Medicaid recipients, inmates, and others. But is that $3 billion being spent on care that is proven to be cost-effective?

The Department of Labor & Industries uncovered an interesting news story in the latest New England Journal of Medicine highlighting
Washington's innovative Health Technology Assessment program.

The Legislature created the HTA when it passed HB 2575 in 2006. The legislation was co-sponsored by Reps. Eileen Cody and Dawn Morrell, who both work as nurses and head the House Health Care Committee, as well as Jim Moeller.

They wanted to bring an evidence-based approach to figuring out what kinds of medical devices, procedures and tests are effective and deliver the outcomes promised by manufacturers. This information is intended to help the various state agencies that administer health care programs make more informed coverage decisions.

The HTA has only completed about a dozen assessments to date, due largely to their comprehensive nature. But those assessments have uncovered an estimated $21 million in savings.

For example, in screening for colorectal cancer, the HTA determined that a CT colonography isn't as cost-effective as a colonoscopy, which would have to be done anyhow if a colonography finds polyps. By not approving CT colonographies, the state will save an estimated $11 million a year.

The HTA is now planning their next round of assessments. If you have feedback, let them know.

Thursday, November 5, 2009

Reducing prison beds in our state – what do you think?

During the 2009 session, the Legislature asked the Office of Financial Management to draft recommendations for closing or consolidating institutions in the Department of Corrections, and in the Department of Social and Health Services’ Juvenile Rehabilitation Administration and Division of Developmental Disabilities programs.

These reductions had to consider capital costs, economic impacts on communities, impacts on facility staff, projected savings and availability of alternative services for individuals with developmental disabilities.

The consultant hired to manage the review issued their preliminary report last month, causing quite a stir in numerous local papers. The final report was issued this week and the Legislature will take it under consideration in January.

As the list below shows, the prisons population in Washington has climbed precipitously the last few years – we incarcerate nearly three times as many people today than in the 1980s, despite the fact that crime has actually decreased.

Prison inmates per 1,000 residents (18 to 49 years old)

1980: 2.3

1990: 3.1

2000: 5.2

2006: 6.1

2020: 7.5*

2030: 7.7*

(*forecasted rates, if policies stay the same)

Why? A big reason is mandatory sentences for non-violent drug crimes.

The increased prison population comes at an increased cost. Each prison cell costs about $100,000 in taxpayer dollars to build and each prisoner costs about $35,000 per year to feed, clothe and guard.

To make our streets safer, lawmakers have passed reforms over the last decade to give longer prison sentences to sex offenders and violent criminals. To make room for these bad guys, we are helping non-violent drug offenders get clean and stay out of jail.

Now, with the budget so tight, some are suggesting additional reforms, such as giving judges more leeway when they hand down sentences instead of making it strictly a mathematical process. This is in addition to the three options for DOC and DSHS facilities recommended in the study. Stay tuned!

Monday, November 2, 2009

Snohomish County legislators urge Congressman Larsen to support strong public option for health care

Four Snohomish County legislators sent a letter to Congressman Rick Larsen last week, expressing their support for a strong public option in federal health care legislation.

Representatives Marko Liias (D - Mukilteo), Mary Helen Roberts (D - Lynnwood), John McCoy (D - Tulalip) and Mike Sells (D - Everett) wrote on October 28: "We cannot continue to allow hardworking Americans to be ruined by the high cost of health care. Hundreds of our constituents are forced to declare bankruptcy every year due to unpaid medical bills."

The purpose of the letter was to let Congressman Larsen know how important a public option is for constituents of Snohomish County, because it would serve as a fallback option for those who have no other coverage. As the health care debate continues in Washington DC, state legislators are hearing from people in their districts about lack of coverage or coverage that is too expensive for them to afford.

The U.S. Census Bureau estimates that 47 million Americans are currently uninsured. The Washington State Insurance Commissioner announced in June that 876,000 Washingtonians lacked health care coverage, a 21 percent increase over the previous year.