John LaPlante
John R. LaPlante is the managing editor of both the StateHouseCall blog and the State Policy Blog. Mr. LaPlante has written on a range of public policy issues since 1998, including health care and education. His writing credits include the Detroit News, the Minneapolis Star-Tribune, the Saint Paul Legal Ledger, and the Wichita Eagle. He holds an M.A. in political science from The Ohio State University.
Friday, May 16, 2008Price-Fixing in Government Health CareBy John LaPlanteP.J. O'Rourke's recent talk to a Cato Institute audience (PDF link) is worth a read, in some measure because of his comments on health care politics. "Another thing that gets me about Hillary is this: why is price-fixing such a great thing when she does it, but if a couple of businessmen get together on the golf course that's a big crime?" Since the name of this site is State House Call, I'll say this: Substitute the name of any number of governors and legislators for "Hillary," and the problem remains. So often, government attempts at "health care reform" mean government-imposed price controls on health care services.
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Thursday, May 15, 2008HSAs for State EmployeesBy John LaPlanteCategories: HSAs, etc., MichiganThe Mackinac Center for Public Policy suggests a way to save taxpayer money, and advance a patient-centered approach to health care at the same time: shift state employees to high-deductible health insurance plans coupled with health savings accounts (HSAs.) The state would come out ahead even if it maxed out the annual contribution to the HSA each year and also paid all of the premium for the insurance policy. Michael D. LaFaive and James Porterfield estimate that the state could save $16.2 million in the first year alone.
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Thursday, May 15, 2008Looking for Answers in all the Wrong PlacesBy John LaPlanteCategories: MinnesotaPeter J. Nelson, of the Center of the American Experiment, has been watching the designs of lawmakers in Minnesota's capitol. Though there has been a lot of legislative activity since he wrote this essay, the principles endure. He writes in part:
Nelson then explains that much of the problem with health care today is the "near absence of health-plan consumerism" and lack of competition among health care providers.
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Thursday, May 15, 2008Medica Rolls out Comparison ToolBy John LaPlanteCategories: Minnesota, North Dakota, South Dakota, WisconsinIf patient-centered care is ever going to take hold in health care, we're going to need some tools to help people figure out which doctors, hospitals and clinics are doing the best jobs at the lowest prices. Fortunately some tools are being developed. One is Angie's List, which is expanding its "tell your neighbors" approach from lawn care services to health care. Meanwhile Medica has developed Main Street Medica, which lets you rank physicians, clinics, and hospitals by price, number of patients seen, and other criteria. It's far from perfect, but it's a good start.
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Wednesday, May 14, 2008Are Patients Stupid?Angie's List says "We don't think so" By John LaPlanteLast month I wrote about the fact that Angie's List, a consumer-referral service, had started helping its members rate doctors, clinics, hospitals and pharmacies. In the May edition of its consumer magazine, the company published several articles about its decision to enter the arena of health care information. (You might be able to read a version of the magazine if you click here.) Here's a brief rundown of what you'll find. Editor Sue Wiltz says that 76% of readers think that the company has a good idea. Some health care professionals say that online ratings can boost business and improve patient satisfaction. Some, however, argue "that patients aren't savvy enough to accurately evaluate care." In "Rx for health care," Chris Austin says that offering people the ability to "discuss their experiences in a forum like this one acknowledges that people have decisions to make in how they spend their health care dollars." He adds, however, that the idea of being rated on performance rattles some people. "Picking your medical professional," meanwhile, offers 6 tips. Finally, "THE Angie of Angie's List" gives her take on it all. "I don't know how to fix a clogged drain or re-side my house," she says, "but I can certainly tell you whether the professional I hired for the job does." Companies such as Angie's List aren't the only means of improving health care, of course, and there's always going to be a place for people who devote their lives to learning about the human body and helping others with their health. But the genie is out of the bottle, and the increased availability of information not only about medicine but about its practitioners will serve us well.
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Tuesday, May 13, 2008You Will Eat Healthy and You Will Enjoy ItBy John LaPlanteCategories: Nanny StateOne year I lost 8 pounds on a family ski trip. One reason was that I didn't eat every portion of every meal, a trick I picked up from a story on CNN that revealed just how calorific restaurant meals are. CNN was helpful by telling me information I could act on, or not. But as Ian Mount writes in Fortune Small Business, some cities are rather impatient: They want to require restaurants to put calorie count on their menus. Why? Oh, the community aspect, you know. My health has become the mayor's business, it seems. Government fascination with controlling behavior is nothing new--think back to Prohibition, for example. But it's an overstep, a blurring of the appropriate lines between government and civil society. As the story notes, some restaurants are voluntarily disclosing such information, though it's hard to know to what extent that's happening as a way to appease government nannies who are making noises about requiring it. Cities with personal dietary police include New York; San Francisco,; and King County (Seattle) Washington. Of course, these requirements also impose financial costs to restauranteurs, who must pay for nutritional analysis and redo their menus. And presumably they may lose some business once customers find out that the plate of cheesy fries contains more calories than nutritionists recommend for an entire day. If a businesses wants to use disclosure as a marketing advantage, I say go for it. But with NYC banning trans fats, we may be on a greasy slippery slope to a world in which cities and states create a Department of Approved Food. Then we'll be transported to the joke about heaven and hell. In heaven, the cooks are French. In hell, they're English. And in modern America, the bureaucrats decide what the cooks serve.
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Friday, May 9, 2008More on Georgia's ReformsBy John LaPlanteCategories: GeorgiaAs Kelly McCutchen mentioned yesterday, Georgia has enacted some significant health care reforms. Jim Frogue, of the Center for Health Transformation passes along some follow-up information, saying "Keep an eye on the Georgia health insurance market these next few years." If you'd like to see what the legislation actually looks like, click here and here. You can also, he says, find copious amount of background information from the center.
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Thursday, May 8, 2008Minnesota County to Scan ResidentsBy John LaPlanteCategories: Minnesota, Nanny StateOfficials in Carver County, Minnesota, are thinking of screening all residents. From the Minneapolis StarTribune:
Sounds a little too much like Big Brother--or maybe Mighty Mother--to me. Is health a good thing? Obviously. Should the political process ("health officials" are paid by tax dollars and supervised by politicians) be the means? Granted, we're talking slippery slope here. But we've already slipped, from the mere exhortation (say, FDA food dietary recommendations) to prohibitions on consumer choices (bans on trans fats) in the name of health. Think of all the things that affect your health: the foods you eat, how much you eat, when you eat, what sorts of leisure activities you engage in, whether you work inside or outside, at a desk or on your feet, whether you .... The net is cast pretty widely, isn't it? To continue from the article:
Personal habits ... Yeah, just the kind of data that government ought to have on people in a free society, don't you say?
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Thursday, May 8, 2008Tennessee Plan: A Symbolic EffortBy John LaPlanteCategories: TennesseeState officials are keen on ways of expanding the number of people who have health insurance--but sometimes you've got to wonder if they're actually looking at what they are proposing. The key to insurance is that it should pay for unpredictable, expensive care. Yet one program has it all wrong, says Drew Johnson of the Tennessee Center for Policy Research: "Imagine if your car insurance paid for oil changes and new wiper blades, but left you on your own if your car were stolen or totaled in an accident. Unfortunately for enrollees, that’s how CoverTN operates."
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Thursday, May 8, 2008Health Vouchers for All?By John LaPlanteCategories: MichiganLast fall, Jack McHugh, a senior legislative analyst with the Mackinac Center for Public Policy, gave the Michigan Health Insurance Advisory Council, a "whirlwind tour " of health care from a free-market perspective. My favorite part of his talk came when he called Medicaid an "attractive nuisance." Less attractive but intriguing is what he calls "a minority position" among free-market thinkers is a call for voucherizing current health care spending.
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