In March, 2010, J. Todd Foster, editor of the Pulitzer Prize-winning Bristol Herald Courier wrote:

“Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States. Although America leads the world in spending on health care, it is the only wealthy, industrialized nation in the world that does not ensure that all citizens have coverage.”

In March, 2010, J. Todd Foster, editor of the Pulitzer Prize-winning Bristol Herald Courier wrote:

“Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States. Although America leads the world in spending on health care, it is the only wealthy, industrialized nation in the world that does not ensure that all citizens have coverage.”

If the U.S Supreme Court does not overrule the individual mandate in the Obama Health Care Bill – or some other key feature – more Americans will have health insurance than ever before, but even then, some will not be covered, largely because the bill’s Republican opponents managed to limit the bill’s reach.

Recognizing that possibility, in September The National Conference of State Legislators (NCSL) invited legislators and administrators from four states without elections this year to convene in Charlotte, N.C., to discuss measures that might be taken to improve the health of the residents of their states. At least two Senators and two delegates, along with staff and/or physician leaders from New Jersey, Louisiana, Mississippi and Virginia gathered to “hear from leaders in health policy about successful ways to allocate limited health dollars more effectively and efficiently.” NCSL hoped that these discussions would cause re-examination of health policies in four states – and perhaps beyond.

Virginia’s participants included Senator Fred Quayle from Virginia Beach, Senator George Barker from Fairfax County, plus Delegate Scott Garrett from Lynchburg (a physician), Robert Vaughan, staff director of the House Appropriations Committee, and me. The Virginia delegation also included Dr. John Dreyzehner, District Director of the Cumberland Plateau District Health Department in Southwest Virginia and staff directors from the Virginia Department of Health and our own Department of Medical Assistance Services (MEDICAID).

The  conference involved discussion within states and across party and staff-legislator lines, and resulted in a focus on possible state actions that could maximize state dollars in a time of revenue reductions and cutbacks.

The Virginia representatives, as well as officials from the other three states, focused more on pubic health initiatives such as reducing smoking, low birth-weight babies and obesity. In part those priorities were established because state budgets are severely constrained, and it appears very unlikely that health care costs will not be adequately contained without giving addressing and reducing key causes of the burgeoning health care costs.

While final reports of the conference are yet to be written, it is safe to say that Virginia representatives, as well as officials from the other three states, decided to place more emphasis on health reform and public health issues in order to reduce costs of providing care to those who are sick.  In short, we decided that, for example, reducing smoking, obesity and low-birth-weight babies were at least as urgent as increasing funding for medical treatment and hospitalization, partially because funding is limited, and achieving public health goals will reduce costs with relatively smaller expenditures.

Delegate Scott represents the 53rd District in the Virginia House of Delegates. He may be emailed at deljscott@aol.com