By Tyler Taylor, MD
In his letter “Council’s Action on Health Care” (link) of Nov. 17, 2018, Richard Nebel made several assumptions regarding the NM Health Security Plan, which I believe are incorrect. One is that this statewide co-op style plan would be run by “the same people who brought us DMV“. In fact, the HSP would not be run by a state government department. Instead, it would be managed by an independent, geographically-representative commission of 15 citizens serving on a per diem basis.
The transparency requirements for this commission are very high, and it’s members must be covered by the very insurance co-op they are managing. Also, this plan is funded with premiums paid to the plan, and not increased taxes.
Secondly, no federal insurance plans – including Medicare – can legally be rolled into a state (or private) plan like the NM Health Security Plan. For the same reason, there are others not covered by this plan: Native tribes, federal employees, members of the military, and those with ERISA-protected insurance (for ex. Triad or Intel employees). In future years, those groups (excluding federal employees and military folks) could choose whether or not to get their coverage through HSP.
Since Medicare recipients will not be part of this plan, there need be no fear of the “benefits cuts” or “cost increases” Mr. Nebel warns of. About 35% of Medicare patients, though, now get their coverage via an “Advantage Plan” offered by Presbyterian, Blue Cross, etc. Someday the HSP may be another such federally-approved option for those wanting an Advantage Plan. (It’s unlimited choice of Providers would make it a strong competitor in that market.)
The HSP has numerous other benefits, including saving New Mexicans hundreds of millions of dollars per year. That is why Resolutions of Support for the related bill by our County Council and The Albuquerque City Council got unanimous, bipartisan support last month. I see the HSP as NM saying “Enough is enough. Since Washington can’t get its act together, and the current health system is a costly mess, we’ll create our own less-expensive, good quality plan to solve many of the problems.”
Hard as it may be for some people to imagine, NM’s health insurance system may well be the envy of many Americans by 2023. I strongly suspect hundreds of fed-up US physicians would then move here to have a saner work environment. It would be a shame for Mr. Nebel and others to leave now, in an ideological huff, just when a giant breakthrough is so possible for New Mexico.