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April 17, 2024

 

Good afternoon SCRWC members and associates, 

 

I am sharing with you a letter I wrote to the Delaware General Assembly and sent to the Cape Gazette and the Coastal Point.  It speaks to HB350 - the bill we spoke about at our meeting last month.  In my opinion, while I understand the need to address the rising cost of healthcare we are seeing in DE, this is a very wrong approach on many levels.  

 

I’d be interested in hearing your thoughts on this issue.

 

                                                                                    April 16, 2024

Dear Delaware Legislators,

 

As a Registered Nurse who relocated to Sussex County, Delaware upon my retirement, I am very dismayed that HB 350 is being considered in the General Assembly.  

 

I understand the concern that healthcare costs are out of control in this, my adopted state.  It appears from what has been said that the impetus for HB 350 is the state looking at an expected increase of 27% in premiums for employees and retirees.  However, I believe that adopting a plan that puts the government in the middle of monitoring hospital budgets is not the correct approach. I agree with the Delaware Hospitals and with Brian Frazee, CEO of the Delaware Healthcare Association.  This is not a good plan.

 

Delaware has a problem with its healthcare system.  Cost is not the only issue. I would submit that some of the reasons our state is seeing drastic increases in medical and insurance costs is easily linked to the fact that Kent and Sussex Counties and some areas of New Castle County are designated by the Federal Government as Medical Underserved Areas (MUA’s) and its citizens as Medically Underserved Populations (MUP’s). A person new to the area, and there are certainly many of those, who has a medical issue and is trying to find a primary care provider is likely to have to wait 2-3 months for an appointment.   By then whatever the issue is likely to have exacerbated requiring multiple types of medical interventions and possibly hospitalization. As a last resort, the person may decide to go to the Emergency Room rather than wait to see a provider as an outpatient.  We all know that ER visits are much more expensive than primary care visits.

 

Having spent most of my career in teaching facilities with physician residency programs in the Baltimore area, I know first-hand that there are certain criteria these newly minted physicians consider when determining where they want to practice.  They are usually married to other professionals and may have young families.  There is a dearth of professional jobs in the state and the further south you go, the fewer there are. In addition, if they do not already have school-aged children, they are likely planning to start a family.  They want their children to attend good schools.  We are unable to offer that and even if they are looking for private schools we have few of those. I postulate that if we fix the schools, we stand a better chance of recruiting more physicians.  Representative Shupe’s HB 192 is a step in the right direction by requiring failing Schools to devise plans for remediation.

 

There are other tactics that the General Assembly could evaluate to lower costs.  Delaware has a CON (Certificate of Need) law.  This was originally intended to make health care more affordable.  More than five decades later, the research shows these laws are more likely to contribute to higher costs.  Further, the Federal Trade Commission has concluded: “The majority of studies fail to establish any definitive link between CON laws and lower unit costs.” In addition, research conducted by the Center for Health Services Research at Georgia State University found that “increased CON rigor is associated with higher costs.”  There are multiple examples in many other industries that show competition drives down costs and improves efficiency. CON’s thwart competition. Hospital competition, efficiency and technology are key to lowering costs - not government interference.

 

I am surprised that the sponsor is suggesting that this Diamond State Cost Review Board, with its politically appointed commissioners, will be fashioned after Vermont’s cost review system.  According to the Kaiser Family Foundation, between 1991 and 2020, Vermont’s annual health care spending per capita grew faster than any other state's.  

 

So, I would say to you in the words of that Delaware icon of all that’s good and holy, Joe Biden, “DON’T!’”

 

Marilyn F. Booker, RN, MS

President Sussex County Republican Women’s Club

Frankford