Indianapolis Business Journal. January 20, 2023.
Editorial: Legislature’s efforts to control health-care costs a good start
We’re pleased that the Indiana General Assembly kicked off its 2023 session this month by making good on its promise to try to find ways to lower Indiana’s health care costs.
Out of the gate, Republican leaders in the Indiana House and Senate proposed several measures aimed at cutting costs they have described as “out of control.” They base their assessment largely on a 2020 study by the Los Angeles-based Rand Corp. that shows expenses charged by Indiana hospitals to cover their overhead and keep the doors open are the fifth-highest in the country.
Bringing these costs under control is key to keeping Indiana an attractive place for employers to do business. And hospitals, insurance companies and drugmakers across the state should work in good faith to help the Legislature make it happen.
We’re particularly pleased lawmakers are pursuing legislation to help control drug prices by putting the squeeze on pharmacy benefit managers. These powerful middlemen negotiate drug prices among pharmacies, drugmakers and health insurance plans but are often less than forthcoming about how big of a slice of pay they keep for themselves.
IBJ’s editorial board in July called for tighter controls on these price-setters. The Legislature’s solution is contained in Senate Bill 8. It would require the middlemen to pass along all the rebates they receive from vendors to patients or to insurance plan members.
Failure to do so could result in a fine of up to $10,000 per violation. One problem is that the requirements would have to be enforced by the Indiana Department of Insurance, an agency that many already consider to be overburdened.
We’re also happy the Legislature is considering several other approaches to control costs. We reserve judgment on those measures, largely because we don’t claim to be experts on the highly complex issue of health care reform but also because we want to learn more as the Legislature debates each proposal.
Among those measures are:
— Senate Bill 7, which aims to promote competition in health care by prohibiting a physician from receiving compensation for referring a patient to a health care entity or another physician.
— Senate Bill 6, which seeks to increase transparency on where a medical procedure is performed for billing purposes. Now, medical providers can charge more for a procedure if it is performed in a hospital-owned clinic rather than an independently owned one.
— House Bill 1004 would fine hospitals that charge more than 260% of what Medicare reimburses for services.
In the case of the last bill, the Department of Insurance again would be called upon to process price disclosure forms submitted by the hospitals, and determine which ones should be fined.
We welcome a full debate of all these measures. And, in the end, we hope the Legislature will see to it that the Department of Insurance is properly funded and staffed to enforce whatever approaches are ultimately approved.
Fort Wayne Journal Gazette. January 20, 2023.
Editorial: It’s past time to destigmatize HIV in Indiana
While we can’t turn back time, a bill introduced in the General Assembly is a reason for Hoosiers to rejoice in a bit of science-based progressiveness.
Legislation introduced by Rep. Wendy McNamara, R-Evansville, would remove fear-based legal logic that goes back 30 years when panic overtook reason. The bill would remove sentencing enhancements for battery and malicious mischief related to HIV. It would also remove specific offenses concerning donating, selling or transferring blood that contains HIV.
However, and rightly so, the law as now written provides that it is a Level 6 penalty if a person with a communicable disease knowingly fails to inform a person at risk with the intent to cause harm to the health of another.
The bill is currently with the House’s Committee on Courts and Criminal Code. It’s time to allow this to pass through both chambers and be signed by Gov. Eric Holcomb.
“I think by having that perception and growing up with that fear that we were going to die … it predominated (my) generation,” McNamara said last fall. “Science has changed and so we’re going to take (House Bill 1198) and focus on … really trying to reverse the stigma that’s attached to it.”
Unfortunately, our treatment of individuals with human immunodeficiency virus infection hasn’t kept up with the medical breakthroughs. In the ’90s, a diagnosis was a prelude to acquired immune deficiency syndrome or AIDS and almost-certain death.
Last February, Jeff Markley, executive director of the Positive Resource Connection, formerly the local AIDS Task Force, highlighted the new reality in a Five Questions feature.
“One of our biggest growing programs is our PrEP program. PrEP is a medication that, when taken as prescribed, will prevent HIV-negative individuals from becoming HIV-positive regardless of the activities in which they engage,” Markley told The Journal Gazette.
“In the ’80s and ’90s, HIV-positive individuals were likely taking multiple medications, multiple times a day – some every four hours – and with significant and often debilitating side effects. Today, the option exists for most clients to take just one pill a day with little to no side effects.”
Decriminalization of HIV is necessary and overdue. Destigmatizing HIV, however, can only come from all of us through education and compassion. And it must come soon because fear combined with a lack of knowledge keeps people from being tested and treated.
As we’ve pointed out, about 17% of Hoosiers with HIV are unaware of their status. Furthermore, Black women are disproportionately affected by the disease. Black women are 10% of the female population but account for 53% of newly reported HIV cases.
We laud the efforts of politicians to bring the discussion of HIV. Now we hope the legislature will flex its political will and financial strength to destigmatize HIV. Funding public health and education is a good place to start.
Terre Haute Tribune-Star. January 19, 2023.
Editorial: An unwelcome plan to politicize school boards
The spin was subtle, but significant, in a Republican announcement of a proposed bill to end Indiana’s long history of nonpartisan school board elections.
A news release from the Indiana House Republicans said, “State Rep. Alan Morrison (R-Brazil) authored legislation that would boost transparency in Hoosier school board elections by allowing candidates to declare a party affiliation.”
So, it apparently would “allow” folks wanting to serve on their local school board — already one of the most thankless jobs in public service — to declare a political party affiliation. They could, at last, fully join in the wonderful world of partisan politics, circa 2023, where each side demonizes the other, acceptance of ideas from the opposite party is forbidden by party bosses, and no proposal moves forward without approval up the chain of party command.
“Allow” sounds optional.
Actually, that is not how the bill reads. House Bill 1074 “provides that for school board offices, each candidate’s affiliation with a political party or status as an independent candidate must be stated on a petition of nomination and on the ballot.”
The proposed law would, in reality, force people wanting to serve on their local school boards to decide to wear the party label of “Republican,” “Democrat” or “Libertarian” unless they choose no party and run as an independent. The predominance of Hoosier school board members who are not overtly political would have to get overtly political, or go it alone as an independent.
And, how often do independent candidates — who have no party endorsements or support — win partisan elections in Indiana? Rarely.
Instead, the plan to immerse local schools in party politics is meant to give the ruling political party even more control over Hoosiers’ lives. This scheme is pitched under a shiny, expedient coating of “empowering parents,” but it is really aimed at forcing school board members to carry out the state and national party leadership’s outrage-issue-of-the-month to win elections. Kids receive a weakened education as a result.
Party officials would probe candidates even after they declared a party. Under the proposed law, candidates must have selected a ballot from their declared party in the two most recent primaries. If not, the county’s party chairman must certify a candidate’s declaration. Again, it is about control.
The party controlling the local school board also can then influence hiring decisions. A Republican dominated board could choose not to approve contracts for teachers, coaches, principals, counselors and staff members they suspect to be Democrats, and vice versa. The divisive, us-versus-them mess that stagnates Congress would unfold in the community school, sucking up the oxygen and energy that should be devoted to efficient, thoughtful, day-to-day operations.
The most recent election in Vigo County itself refutes the bogus claim that attaching a “R,” “D” or “L” to a school board candidate’s name provides better information to voters than the nonpartisan system. Voters in November’s election closely scrutinized the 14 nonpartisan candidates on the ballot to get their takes on last year’s turned-down school construction referendum and other issues. Candidate forums were heavily attended, too. Party labels would have added nothing helpful and only blurred the pertinent information.
Those are the reasons that only four states force candidates to wear party labels in school board elections. Indiana should not join that list.