SENATE MEMORIAL 3

49th legislature - STATE OF NEW MEXICO - first session, 2009

INTRODUCED BY

Mark Boitano

A MEMORIAL

REQUESTING THE NEW MEXICO MEDICAL SOCIETY AND THE NEW MEXICO HOSPITAL ASSOCIATION TO CONVENE A TASK FORCE TO STUDY AND MAKE RECOMMENDATIONS REGARDING COSTS FOR HEALTH CARE PROCEDURES.

     WHEREAS, the health policy journal, Health Affairs, reports that employers and other payers of health care costs paid two trillion four hundred billion dollars ($2,400,000,000,000) in health care costs in 2008; and

     WHEREAS, Health Affairs reports that health care costs are projected to reach three trillion one hundred billion dollars ($3,100,000,000,000) in 2012 and four trillion three hundred billion dollars ($4,300,000,000,000) by 2016; and

     WHEREAS, the commonwealth fund reports that while health care costs continue to rise exponentially year after year, consumers of health care remain greatly uninformed about these costs because little comparative information on cost and quality among health care providers is available; and

     WHEREAS, the United States census bureau's August 2008 current population survey reports that the number of New Mexicans without health insurance has grown to twenty-two and five-tenths percent; and

     WHEREAS, America's health insurance plans, an insurance trade association, recently released the results of a census indicating that four million five hundred thousand Americans are now covered by high-deductible health insurance plans that include health savings accounts; and

     WHEREAS, according to America's health insurance plans, approximately twenty-five percent of all new health savings plan enrollees nationwide were previously uninsured; and

     WHEREAS, uninsured individuals and individuals covered by health savings plans must pay directly for all or a large part of their health care without the advantage of fee rates negotiated by large insurers; and

     WHEREAS, being informed of the cost of health care procedures and supplies is essential for anyone who must budget to cover health care costs out of pocket, as well as integral to the viability of participating in health savings plans; and

     WHEREAS, patients who pay out of pocket for health care report that health care procedures may involve a great number of costs, such as facility fees, laboratory testing fees, pharmaceutical and health care supply costs and associated health professional fees, such as for anesthesiologists, all of which are charged in addition to physicians' fees and that often come as a great surprise to a patient who pays out of pocket; and

     WHEREAS, the federal department of health and human services' centers for medicare and medicaid services has recognized the need for the roughly forty-three million individuals covered by medicare to learn the cost of common medical procedures and posts this information on its web site; and

     WHEREAS, while pricing information pertinent to medicare is not applicable to individuals paying out of pocket or through private insurance, the availability of this information to medicare enrollees demonstrates the feasibility of compiling this information for individuals paying out of pocket;

     NOW, THEREFORE, BE IT RESOLVED BY THE SENATE OF THE STATE OF NEW MEXICO that the New Mexico medical society and the New Mexico hospital association be requested to convene a task force comprised of representatives from the New Mexico medical society, the New Mexico hospital association, the university of New Mexico health sciences center, Presbyterian medical services, patient and consumer advocacy organizations, private insurers and health maintenance organizations and any other organizations that they deem able to provide constructive input regarding the design and implementation of a system whereby health care consumers and payers may be informed of costs for health care procedures prior to undergoing those procedures; and

     BE IT FURTHER RESOLVED that the task force study and prepare recommendations on the following: the feasibility for making estimates of health care costs to anyone who requests them prior to a particular health care procedure; whether instead of providing a system for obtaining estimates on individual procedures, the medicare model of posting estimates for a set of common health care procedures is most appropriate; the allocation of the reporting burden among health care facilities, providers or any other persons; delimiting the types of procedures for which this information should be available, whether they are inpatient, outpatient or in another delivery setting; the procedure and format for reporting health care costs associated with procedures; and whether any penalties or other protocol should be implemented to address inconsistencies between an estimate for and the ultimate health procedure costs; and

     BE IT FURTHER RESOLVED that the task force be requested to report its recommendations to the interim legislative health and human services committee by October 1, 2010; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the president of the New Mexico medical society, the president of the New Mexico hospital association and the executive vice president for health sciences at the university of New Mexico.

- 5 -