AN ACT Relating to the study of health care allocation; creating new sections; making an appropriation; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. This act may be known and cited as "the Washington health care allocation act of 1990."

NEW SECTION. Sec. 2. The legislature finds that although Washington state has made significant expansions in publicly financed health services, major problems persist regarding (1) allocating needed services to low-income groups, (2) reducing expenditure for the delivery of marginally effective or relatively expensive services with limited value in lengthening life, (3) changing the health care system's orientation from restorative to preventative care, (4) mitigating the negative effects of professional liability litigation on health care service delivery and costs, (5) increasing the efficiency and accountability of the health care insurance industry, and (6) reducing overall administration costs. Because these problems have not been adequately addressed, the number of persons without access to preventative and restorative health services continues to grow at an alarming rate and health service costs continue to rise well above the rate of inflation.

The legislature is concerned about the effect health care costs may have on the state's ability to be competitive in the international economy. In particular, the legislature is concerned about the effect growing health care costs may have on small businesses, since some reports suggest small employers have been experiencing increases in employee health costs at six times the rate of inflation. The legislature is concerned that this may have resulted in a sharp decline in the capacity of employers to provide health care coverage for their employees.

The legislature concludes that efforts to resolve these questions and to solve these problems must involve discussion among all major components of health service delivery and finance. The legislature further concludes that the state health report prepared by the board of health with assistance from the department of health provides the structure for needed study and balanced public discussion of these important problems.

NEW SECTION. Sec. 3. (1) The state board of health shall complete and submit to the legislature a special study of the health care system by November 1, 1991, as a supplement to the state health report.

(2) The board may hire staff or contract for professional assistance within funds appropriated for the state board of health. State agencies, the senate, and the house of representatives may provide staff support upon request of the board. The board may apply for and receive grants, gifts, and other payments from any government or other public or private entity or person.

(3) The board may establish ad hoc technical advisory committees as necessary and may reimburse committee members for related travel expenses from funds appropriated to the board.

(4) In the conduct of its business, the board shall have access to all health data available by statute to the secretary of health. The secretary shall provide the board with all requested health data or other relevant information maintained by the department in a timely and easy-to-comprehend manner, together with such reasonable presentation, discussion, and analysis as the board or its staff may request.

NEW SECTION. Sec. 4. (1) The board shall conduct an analysis and develop a series of recommendations as to which health services should be provided to all citizens through a combination of public and private financing, along with a phase-in schedule. The report shall include:

(a) A list of proven health promotions and disease prevention programs which should be implemented by local and state health agencies, or otherwise financed, including screening, assessments, and education;

(b) A prioritized list of primary health and social services that do the most to promote long and healthy life while avoiding excessive cost;

(c) A list of minimum health and social services that should be accessible to all citizens within the state, based on the prioritized list in (b) of this subsection, to include at least hospital, medical, and long-term care services;

(d) A method for holding private health insurance providers, health care service contractors, health maintenance organizations, and other health care payors publicly accountable for their efficiency and effectiveness in financing health and social services;

(e) A clear and comprehensible policy as to the segments of society for whom public financing and private financing of health and social services should be required; and

(f) An analysis of the current issues relating to medical malpractice liability and insurance, and recommendations to reduce its effects on health and social service access and costs, including an analysis of the desirability and feasibility of a publicly funded malpractice insurance program.

(2) The study shall encompass financing and services now included within at least the following programs: Medicare, medicaid, workers' compensation, all other publicly financed health services, and all privately financed health services.

(3) The report shall also include an analysis of all state and federal laws that would need to be repealed, amended, or waived to implement the board's recommendations.

NEW SECTION. Sec. 5. The sum of .......... dollars, or as much thereof as may be necessary, is appropriated for the biennium ending June 30, 1991, from the general fund to the board of health for purposes related to implementation of this act.

NEW SECTION. Sec. 6. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately.