Why Idaho Ranks Number Three in U.S. Health Ownership

As the nation debates President Obama’s “public option” for health care, the citizens of Idaho have an important contribution. Idaho enjoys considerable freedom in health ownership compared to the rest of the United States, according to a new study.

The 2009 U.S. Index of Health Ownership (IHOP) ranks Idaho number three nationwide in health ownership. It is the first effort to measure the degree to which individuals, whether they be patients, health professionals, entrepreneurs or taxpayers, “own” the health care in their states. The index shows that Idaho has one of the smallest burdens of government health care mandates. This translates to lower health insurance costs since state government does not force the insured to buy unneeded coverage such as massage therapy or alcohol abuse treatment.

The Gem State enjoys very low individual premiums, has very light mandates, and is relatively free of regulation. With lighter regulation, fewer citizens must resort to using government provided health care. This translates into greater choice and fewer costs, with total burden of health regulation outweighing its benefits by two to one in terms of incurred costs, according to professor Christopher J. Conover of Duke University.

The issue of health ownership is resonating in Idaho, which follows only North Dakota and Montana in the national rankings. Even as government pushes for more involvement in national health care this year, Idaho has been moving against the tide and up the ranks in individual health ownership. The state ranked 17th in 2007 and sixth in 2008 according to previous IHOP editions, showing a concerted effort to resist unnecessary government intrusion in health care provision.

Idaho is trumping its neighbor states, with the exception of Montana, in resisting such intrusion. Nevada, Washington, Colorado, Utah and Oregon cluster closely together in the middle third of the index’s overall ranking, and Wyoming falls far behind as the 43rd worst state for granting health ownership. The interesting finding is that no state performs well in all categories of state involvement. There is room for improvement, even for Idaho.

While Idaho performs well on the regulation of private health insurance and coverage mandates, it still lags in certain areas including enrollment in government-dependent health care programs like SCHIP. Ranking 22nd overall, Colorado actually ranks far ahead of Idaho (20 positions) in terms of state government health care with well managed enrollment in Medicaid and SCHIP. Even mid-level states have lessons for our top performers to learn in order to give their citizens more health ownership. Every state has room to improve.

“Instead of trying to implement a new government-run bureaucracy,” says an Idaho Press-Tribune editorial, “we should support measures that would allow those Americans who like their coverage to keep it and give all Americans the freedom to choose health plans that best meet their needs.”

The editorial brings up a valid point. Americans should have the right to “own” their own health care. True health ownership would allow Americans to spend their health dollars as they see fit – not according to the preferences of their employer, the government or an insurance company. Unfortunately, federal and state laws work against that right.

Federal tax law forces Americans to accept employer-based health plans, something they would never tolerate for homes or automobiles. States also interfere with health ownership by forcing low-income people into government programs, instead of giving them vouchers to buy coverage that suits their needs.

Such programs restrict choice of health insurance through over-regulation. Malpractice laws make the practice of medicine unaffordable to some doctors. Excessive regulations on hospitals, clinics and allied health professionals quash innovation. Such intrusion results in unnecessary and costly treatment and less choice in how one gets treated, who gives the treatment, and when it happens.

Instead of more regulation and more bureaucracy, all Americans deserve more freedom in health ownership. Federal policy makers could learn a lesson or two from Idaho.

This article was written by John R. Graham, director of Health Care Studies at the Pacific Research Institute in San Francisco, and Kelly Gorton, an associate at the institute and summer resident of Grangeville, Idaho.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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