The whole is almost always worth more than its component pieces. In 1924, Dr. Charles H. Mayo estimated the value of the human body in a light-hearted piece in the Northwestern Health Journal. He approximated the figure at 84 cents. Thomas Edison quipped, “From his neck down a man is worth a couple of dollars a day, from his neck up he is worth anything that his brain can produce.”
More recently, Wired Magazine estimated that the chemical parts of a human body are collectively worth $17.18. But when those chemicals are combined into organs, marrow, and platelets, the value of the average human body sores to approximately $45,618,575.82. Why? Because the whole is worth more than the sum of its parts. This is also the way some legislation works and the way in which some legislation can be evaluated. It’s also the logic I applied to my vote on the bill before the Health and Human Resources Committee in relation to West Virginia’s “Certificate of Need” Law. Here are some things to think about that may help you understand that this bill was not simply about a “free market” approach to healthcare:
1. The bill did absolutely nothing to address the terrible practices and issues related to the Public Employees Insurance Agency (PEIA), which is the one insurance company in West Virginia that refuses to negotiate healthcare prices with healthcare providers in West Virginia. PEIA only pays 50 cents on the dollar for healthcare costs in West Virginia, while Medicare and Medicaid, as well as other insurance companies, routinely pay $1.50 on the dollar to the same healthcare providers in our state. PEIA refuses to negotiate health care cost with healthcare providers in West Virginia, while other health insurance companies do negotiate prices. PEIA routinely denies providing necessary healthcare coverage, routinely refuses to pay for prescriptions that doctors prescribe to their patients, and PEIA will even “shop you around” to other healthcare providers if it is cost effective for them, instead of letting you choose your own doctor or healthcare provider. PEIA is a state agency that manages a health insurance program for local and state government employees in West Virginia and it consistently fails to provide satisfactory and sufficient health insurance to many citizens in West Virginia, but the agency enjoys being exempt from the same regulations and standards to which other health insurance companies are held. This bill failed to offer alternative health insurance plans from which people can choose. Instead, this bill allowed PEIA to continue its unacceptable practice and poor treatment of patients. PEIA must be reformed or replaced with a program to offer health insurance alternatives to state and local government employees.
2. West Virginia is already experiencing a destabilization of the healthcare industry in our state and repealing the “Certificate of Need” requirement would further destabilize and undermine quality of healthcare in our communities. How? There are a couple of ways this would likely happen; 1) Hospitals do not have enough staffing right now to make all of their existing beds available for patients in their service area. For example, a hospital may have 120 beds, but can only take 70 patients because the facility only has enough staffing to adequately care for 70 patients. Employing a “free market” approach at this point in the healthcare industry would only further degrade staffing levels in existing hospitals. Meanwhile, simply repealing CON and allowing anyone and everyone to open ambulatory centers, surgical centers, imaging facilities, hospitals, assisted living facilities, and hospice care facilities would only create a “low bid” environment for healthcare in your community. And this would only further degrade the quality of care for patients.
3. To repeal the “Certificate of Need” requirement in West Virginia would essentially cause the collapse of the financial funding for the Peyton Hospice House (a non-profit end of life care facility) in the district I represent, which could result in the lone hospice facility in our county closing. In its place we would likely see the rise of low-end hospice facilities that simply exist to provide end of life care for the terminally ill for financial profit.
4. Before making my final decision on whether or not I would vote for or against the bill to repeal the “Certificate of Need” requirement in West Virginia, I reached out to and spoke with representatives from the West Virginia School of Osteopathic Medicine, the Peyton Hospice House, the Greenbrier Valley Medical Center, the Pocahontas Memorial Hospital, the Rainelle Medical Center, and a number of doctors located in the 42nd District, which is the district I currently represent. Based on these conversations, the representatives of these organizations agreed unanimously that repealing the “Certificate of Need” statute would cause serious and irreparable harm to the availability and quality of health care in West Virginia, and especially in the availability and provision of timely and quality healthcare in the Greenbrier Valley. There was absolutely no data, no speculation, and no projection offered to the Health and Human Resources Committee in relation to how the repeal of the “Certificate of Need” would actually produce better health care options in West Virginia, instead, what I gleaned from the debate in this issue was one simple idea, which was that the “free market” would work it all out. At this point, that is not a chance I’m willing to take when it comes to the health and welfare of West Virginia’s citizens.
I am always available to discuss your concerns and the issues that matter to you. I will work diligently to keep you apprised and aware of what’s going on in Charleston during this year’s legislative session. I hope you will not hesitate to contact me as we work to move our region and West Virginia forward in the coming year.