Commentary - John R. Graham: State health care indexes require caution

WASHINGTON (Map, News) - These days, more action on health reform appears to be happening in the states than at the federal level, and we heartily approve this for at least two reasons. First, because none of us knows exactly what the “right” answer is for health reform, it makes sense to allow each state to experiment with policies it thinks will work. Reforms that work will jump across state lines, as appropriate, and reforms that do not will cause limited harm.

Second, because each state is unique, it makes sense that state governments remain free to make different choices. Surely Alaska and Rhode Island have different health needs, and it would be absurd to expect the federal government to have the knowledge required to regulate and finance according to local conditions.

Of course, for citizens to understand the consequences of health legislation and regulation, they need indicators that they can use to hold policy-makers to account, and these indicators must identify differences between the states. So it is gratifying to see a number of organizations produce “report cards” that measure health care in all 50 states.

Some of the reports cover very narrow ground. …

PRI’s Index of Health Ownership is unique in that it counts government intrusion as a drawback to good health care, whereas other measurements always count it as a benefit.

» Claims that “access” to health care — often caused by greater government intrusion — leads to higher quality health care rest on shaky ground.

» Much more research is needed to understand the appropriate role of state governments in controlling citizens’ use of health services.

You can read the full study on PRI’s Web site at: liberty.pacificresearch.org/docLib/20070710_HPPv5n7_0707.pdf

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