State health policy developments: Doctor shortages, hospital taxes, California insurance crackdown

News outlets across the country report on state health policy developments.

The Los Angeles Times: "At a time when nearly 7 million Californians are uninsured, state regulators are trying to rein in discount health and dental plans that officials say frequently overstate benefits, offer little if any savings and promise access to doctors who aren't part of the system. Some of the discounters fraudulently market themselves as insurance, while preying on the poor, the elderly and others who urgently need care, officials say. ... Plan executives bristle at such criticism. They say a few bad apples have tarnished an industry that offers reliable -- and relatively inexpensive -- services. Consumers, however, have lodged complaints against more than 150 unlicensed discount health and dental plans over the last four years, prompting the California Department of Managed Health Care to seek new licensing regulations" (Helfand, 2/8).

WZZM, an ABC station in Michigan: "Health care experts say Michigan's expected nursing shortage may not be as bad as once thought. The state was bracing for deficit of nearly 18,000 nurses by the end of the decade. For years the medical community warned how the growing nursing shortage could jeopardize the industry and people's ability to get quality care. ... [Shawn Ulreich, the chair of The West Michigan Nursing Advisory Council] says the medical community has spent a lot of time and money attracting quality candidates to the field to reduce the chances of reaching a critical shortage" (2/7).

Lexington Herald Leader: "[Kentucky] has never had enough doctors. It is behind in primary care, specialty care and care for patients who live in rural areas. About 2,200 more physicians are needed in the state to meet the national standard of 267.9 doctors for every 100,000 people. Kentucky has about 213.5 active physicians for every 100,000 people ... Now, a battle is brewing over how to give Kentuckians more medical attention in the future as the state's residents, already beset by a host of health maladies, grow older and sicker, and more people seek care. In one corner: medical schools, which are both adding new slots for more students and stepping up their efforts to train physicians to work in traditionally underserved rural areas. In the other: nurse practitioners, who are pushing for an increased role in serving patients" (Truman, 2/7).

The Tennessean reports on a possible hospital tax: "Representatives for the hospital industry have suggested bringing back the hospital tax, which expired in 1994 when TennCare was created, to reduce or stave off cuts in state funding proposed by Gov. Phil Bredesen. Those cuts would save the state $380 million, according to one analysis. But they would cost Tennessee two to three times as much in federal aid, amplifying the effect on hospitals and other health-care providers far beyond the state's savings. ... Hospitals estimate that they would lose $526 million in state and federal funding this budget year and next if lawmakers approve the $28 billion spending plan that Bredesen presented to the legislature last week" (Sisk, 2/7).

Standard Speaker reports on loss of nursing homes in Pennsylvania: "Carbon County appears to be joining Luzerne and Lackawanna counties in looking to get out of the nursing home business. In each case, the county nursing home has been viewed as a financial burden to a tightening budget. ... Michael J. Wilt, executive director of the Pennsylvania Association of County Affiliated Homes. ... said selling the county nursing home amounts to a one-time budget boost, and wonders whether the short-term gain is worth it. ... Fifty counties in Pennsylvania once operated nursing homes, but the number is down to 31, according to Wilt" (Ragan, 2/7).

The Salt Lake Tribune reports: "Victims of medical malpractice could see the amount of damages they could receive cut in half under a bill that is likely to pit the state's physicians against the lawyers who represent injured patients. SB145, sponsored by Sen. Stuart Adams, R-Layton, would impose a hard limit of $250,000 available to malpractice victims as a result of pain and suffering. The current limit in Utah is $480,000. ... In October, the nonpartisan Congressional Budget Office wrote in a letter to Sen. Orrin Hatch, R-Utah, that a $250,000 cap on pain-and-suffering awards and instituting other tort reforms could reduce overall medical costs by 0.5 percent" (Gehrke, 2/7).