The only fight fiercer than big hospital groups battling each other for business in South Dakota might be when somebody wants a change in state law to make it easier to take some of their patients.
The two big Sioux Falls health care organizations, Sanford and Avera, joined forces with Rapid City Regional as opponents to a patient-choice law proposed in the Legislature this winter.
The battle came to a peak Tuesday. The state Senate voted 23-11 against a measure that would have let patients choose specialty hospitals and other specialty caregivers who aren’t in their insurance providers’ networks.
“You know what this is: It’s Godzilla versus tyrannosaurus rex,” said Sen. Bruce Rampelberg, R-Rapid City.
The retired bank president said patient-choice would have increased his bank’s expenses and reduced its profits.
The House of Representatives had previously approved HB 1142 on a 39-30 vote. The Senate Commerce Committee amended the House version, adding an expiration date of June 30, 2018.
The purpose of the sunset was to come back in five years and see what the actual data says about whether costs increased, said Sen. Ryan Maher, R-Isabel. That wasn't enough to turn enough senators' minds in favor.
The bill’s lead sponsor in the Senate was Sen. Corey Brown, R-Gettysburg. His family operates an independent insurance agency.
“At the end of the day our relationship is with the customer,” Brown said.
The bill isn’t aimed at Avera or Sanford, Brown said. He said the purpose is to best serve the patient.
But Sen. Mark Johnston, R-Sioux Falls, said there was a long list of opponents, including the association for 7,000 independent agents. One of the opponents was his employer, the Sanford health organization.
Johnston said private hospitals are the main supporters of patient choice. He said their profit margin is much higher because their Medicaid caseload is much smaller than most hospitals.
“This isn’t about any willing provider. This is about any willing dollar,” Johnston claimed.
To participate, physicians would need to be willing to accept the payment levels available from the insurance providers. Why that will increase costs for healthcare wasn’t clear to Sen. Tim Begalka, R-Clear Lake.
Begalka said he decided to vote for the change.
“There’s been a lot of confusion, and I’d agree it’s been on both sides. There’s been some dishonest testimony, on both sides,” he said.
Sen. Jean Hunhoff, R-Yankton, said networks provide continuity of care that is cost effective.
“Anybody can play. If you want to play outside the network, you pay,” Hunhoff, a nurse and an Avera employee, said.
How They Voted
Here’s how the Senate split Tuesday on HB 1194, which sought to allow patients to choose medical providers outside their insurance networks. Senators voted 23-11 to reject the measure, whose prime sponsor was Rep. Hal Wick, R-Sioux Falls.
Yes — Stan Adelstein, R-Rapid City. Tim Begalka, R-Clear Lake. Corey Brown, R-Gettysburg. Ried Holien, R-Watertown. Phil Jensen, R-Rapid City. Ryan Maher, R-Isabel. Al Novstrup, R-Aberdeen. Russ Olson, R-Wentworth. David Omdahl, R-Sioux Falls. Craig Tieszen, R-Rapid City. Mike Vehle, R-Mitchell.
No — Jim Bradford, D-Pine Ridge. Bob Ewing, R-Spearfish. Jason Frerichs, D-Wilmot. Phyllis Heineman, R-Sioux Falls. Jean Hunhoff, R-Yankton. Mark Johnston, R-Sioux Falls. Tom Jones, D-Viborg. Mark Kirkeby, R-Rapid City. Shantel Krebs, R-Renner. Dan Lederman, R-Dakota Dunes. Larry Lucas, D-Mission. Jeff Monroe, R-Pierre. Ernie Otten, R-Tea. Deb Peters, R-Hartford. Bruce Rampelberg, R-Rapid City. Tim Rave, R-Baltic. Larry Rhoden, R-Union Center. Deb Soholt, R-Sioux Falls. Billie Sutton, D-Burke. Larry Tidemann, R-Brookings. Bill Van Gerpen, R-Tyndall. Chuck Welke, D-Warner. Jim White, R-Huron.
Excused — Angie Buhl, D-Sioux Falls.