Opinion: The system must change

Healthcare is complicated, expensive, and frustrating. It doesn’t matter if we’re talking about an annual checkup or ongoing cancer treatments. Very few people can easily navigate the complex rules and policies that drive healthcare and how we access it. We must change it. The physical and financial health of Idahoans demands it.

The Idaho Legislature took a step towards figuring out potential changes. This week marked the first meeting of the Idaho Health Insurance Working Group. The committee is charged with reviewing the performance of Idaho health insurers and the effect of that performance on your health. Then, they’re tasked with making recommendations to the Legislature to fix the problems they find.

There are many other areas of healthcare that need addressing. Idaho has serious provider shortages, especially in our rural communities. We’ve made some improvements by increasing our medical residencies to help bring doctors into the state. But it’s not enough. Too many of you must drive over an hour to access medical care.

Then, there’s the issue of cost. A recent report from the Bureau of Labor Statistics showed that prescription drug prices dropped during the last year. But it happened after years of price increases on life-sustaining drugs like insulin. You and your family can’t afford ongoing increases for medications that may represent the difference between living a normal life and ending up in the hospital.

We also can’t pretend that every healthcare decision can be a financially savvy, thought-out choice. A market economy assumes some level of choice and access to information to help make that choice. But in healthcare, there’s a difference between elective treatments, like having your knee replaced sometime in the next six months, and emergency treatments, like having a heart attack right now.

In the middle of a heart attack, your goal is simple: don’t die. There isn’t a lot of mental space for questions about the cost of who provides your care. In the moment, how do we expect you to know if the ambulance is taking you to a hospital that’s in-network with ER physicians and radiologists who have a contract with your insurance carrier? All that information comes to you after the fact, after the expense has happened, and then you must deal with the financial consequences.

I’ve traveled around the state speaking with many Idahoans, including the people who receive the care as well as those who provide it. I’ve met frequently with insurers and other payers who process the claims and try to forecast the cost/benefit of different treatment options. I don’t view anyone in this system as a hero or a villain. Everyone, you included, is stuck in a healthcare system that isn’t working.

As a member of this committee, I will take everything I’ve learned about healthcare in Idaho and apply it. I will work with the other committee members and the Legislature to find real solutions that improve how you and your family access and receive healthcare. The system must change.