Friday, February 03, 2006

Outsourcing West Virginia's Health Care

The Charleston Gazette reported on House Bill 4359 introduced yesterday by Delegate Canterbury (R-Greenbrier County). House Bill 4359 would allow state employees covered by the West Virginia Public Employes Insurance Agency (PEIA) to go to foreign hospitals for health care services, including surgery. Delegate Canturbury's proposed bill would allow the outsourcing of West Virginia health care in an attempt to introduce more competition into West Virginia's health care system. For more indepth info check out Del. Canturbury's website called www.competitionishealthy.com.

The Charleston Gazette article gave some interesting cost comparisons. For example, the article states that Bumrungrad International in Bangkok, Thailand, a resort-like foreign hospital, performs open heart surgery for under $8,000. The article also cites hospitals in India and Singapore.

The bill takes a unique approach in trying to increase the health care competition in the state of West Virginia and it will be interesting to watch the response by other health care industry groups in West Virginia. I'm especially intrigued by the provision that allows for a rebate of part of the savings directly to the patient/state employee. This type of provision provides a direct incentive for the patient/state employee to be involved in understanding the costs of their own health care.

This trend of overseas outsourcing continues to grow -- whether it be product manufacturing, medical dictation services, radiology services, engineering services, legal services - just to give a few examples. I've read a number of articles over the last year about the coming changes in the legal industry regarding lawyers services continuing to move overseas. It is a challenge that everyone in the service industry better start looking at and preparing for in the future. As Thomas Friedman would say, the world is becoming more flat and connected.

I'm interested to know whether any other state legislatures have introduced similar legislation and the impact the legislation has had on the health care system.

Below is a complete copy of HB 4359 as introduced:

(By Delegates Canterbury, Walters and Eldridge)
[Introduced February 2, 2006; referred to the
Committee on Banking and Insurance then Finance.]

A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §5-16-28, relating to
establishing a system to reduce the cost of medical care paid by the Public Employees Insurance Agency by providing incentives to covered employees to obtain treatment in low cost foreign health care facilities accredited by the Joint Commission International .

Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended by adding thereto a new section, designated §5-16-28, to read as follows:

ARTICLE 16. WEST VIRGINIA PUBLIC EMPLOYEES INSURANCE ACT.
§5-16-28. Authorization for treatment in foreign health care facilities accredited by the Joint Commission International (JCI); Incentives for covered employees; rebate of savings.
(a) Not later than the first day of July, 2006, the director shall establish a program of incentives for covered employees who elect to obtain medical care or medical procedures in health care facilities accredited by the Joint Commission International (JCI) when the cost of the medical care or medical procedure in the foreign health care facility is less than the cost of the medical care or medical procedure available in a health care facility in this country: Provided, That the difference in the cost of the foreign health care is equal to or greater than the total cost of the incentives.
The incentives shall include:
1. Waiver of all co-payments and deductible payments;
2. Payment of cost of round trip air fares for the covered employee and one companion;
3. Lodging expenses in the foreign country for the companion for the length of the treatment or procedure;
4. Lodging expenses in the foreign country for the covered employee and the companion for not more than seven days of convalescence after the treatment or procedure;
5. Payment to the covered employees hiring agency for seven days of paid sick leave which are not counted against the employees accrued sick leave; and
6. Rebate not more than twenty percent of the cost savings directly to the covered employee.

(b) The director shall establish a fund within the agency for the deposit of the remaining eighty percent cost savings. Not later than the first day of July of each fiscal year, the director shall rebate the moneys in the fund in equal amounts to each covered employee.

NOTE: The purpose of this bill is to provide a system to reduce the cost of medical care paid for by the Public Employees Insurance Agency by providing incentives to covered employees to obtain treatment in foreign health care facilities accredited by the Joint Commission International. Under the bill, if there are sufficient savings to do so, covered employees may choose to travel to foreign countries for medical care and treatment with the cost of travel, lodging and the treatment paid for by PEIA. In addition, PEIA would reimburse the employee twenty percent of any savings, pay for the lodging and travel cost of a companion, pay for the cost of lodging for seven days of convalescence and pay the employer for seven days of paid sick leave for the employee.

This section is new; therefore, strike-throughs and underscoring have been omitted.


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