Republican State Treasurer’s Transparency Push Can Fix Healthcare

RALEIGH – Republican State Treasurer Dale Folwell has a knack for shaking up government programs and reforming them for the better, using conservative, no nonsense solutions. He just may be cracking his knuckles to see if he can take on one of the most convoluted, over-regulated, markets out there: Healthcare.

The editorial staff at The Wilson Times optimistic:

State Treasurer Dale Folwell is betting that they can – and he’s looking for a few hundred thousand watchdogs.

Folwell, a certified public accountant elected to the Council of State post in 2016 after serving as a Republican lieutenant governor candidate, state lawmaker and N.C. House speaker pro tempore, thinks it’s time for outside-the-box solutions to skyrocketing health costs.

Noting that many mistakenly thought BlueCross BlueShield administered the state health plan, Folwell redesigned health insurance cards to highlight the fact that the state is self-insured.

“Your state health plan, paid for by you and taxpayers like you,” the cards will now read.

Folwell hopes patients will be more likely to seek the best price from providers and pharmacies and advocate for price transparency reforms when they realize ordinary taxpayers, not a private insurance company, are ultimately footing the bill.

Speaking at the North Carolina Press Association’s annual legislative breakfast in Raleigh last week, Folwell fished a bank card from his wallet.

“None of you in this room pull one of these out of your pocket unless you know the value and the price of what you’re getting,” he said, noting that price factors heavily into many consumers’ gasoline, food and clothing purchases.

Then Folwell held up his health insurance card to illustrate a key difference.

“All of you pull this out of your pocket, which is your health card, and even after you consume [the service], you do not know the value and the price,” he said. “And that’s what we’re going to change. It starts with acknowledging and turning these plan participants 750,000 strong into watchdogs. If I can do that, we’ll be successful.””

Judging by Folwell’s track record, he is likely to be successful and the North Carolina taxpayers, and purchasers of healthcare for that matter, will be better off for it.

The problem with healthcare markets is the separation between price, value, and the third party payer. The lack of transparency and financial detachment between producer and consumer hinders the true price discovery mechanisms that enable free markets to offer higher values at lower prices, and so it always slopes prices up. The same is the case for education, as government monopolized financing removes cost considerations from the equation and colleges therefore jack up prices knowing the demand is guaranteed by Uncle Sam.

“The American health system encourages price inflation and outright overbilling because patients receive care without any concept of cost. They know their co-pays for doctor visits and prescriptions, but the true amount they and their insurer will be asked to fork over comes weeks later in the mail.

Health executives are averse to price transparency because in many cases there is no true price – providers negotiate reimbursements with each individual insurance company. Patients should care when insurers absorb needless markups, because inflated bills ultimately drive up their premiums and raise their deductibles.

“There is no excuse, it’s intolerable, that the biggest purchaser of health care and pharmacy benefits should not be able to do it better and cheaper,” Folwell said.

Advertised prices would allow patients to comparison-shop. If a procedure costs thousands less at Hospital B than Hospital A, and both facilities have comparable quality ratings and reported outcomes, we can vote with our wallets and opt for the care that causes the least financial strain.

The state treasurer doesn’t have the power to require doctor offices, clinics and hospitals to provide estimates or publish price lists. But the General Assembly does, and three quarters of a million state health plan enrollees represent a large constituency with powerful lobbying might.”

While Democrats’ proposals for tackling the ever rising cost of health care is more and more government (And we know what that does – Affordable Care Act, anyone?), conservatives like Folwell understand that fixing the healthcare issue requires more transparency in markets, more straightforward transactions, and more freedom.

If anyone can make a dent in the irrationally structured health insurance industry, Folwell can. And it’s yet another reason that electing conservatives to statewide posts is so important.