The 2025 legislative session kicks off January 21st and think tank Think New Mexico has a set of recommendations that aim to improve the state’s health care system. Founder and executive director Fred Nathan said these recommendations could New Mexico joining a compact among states that would bring in more doctors to address professional shortages and other measures that would protect patients.
Think is recommending lawmakers set aside $2 billion for a permanent fund to address the state’s many health care needs.
Founder and Executive Director, Fred Nathan said a permanent fund would help lawmakers avoid raising taxes or cutting spending on necessary programs and could help one of doctors' major complaints, which is low Medicaid reimbursement rates.
"Unfortunately some doctors can’t see Medicaid patients because they can’t make their practice viable. So this is a way to help Medicaid patients and also attract and retain doctors" said Nathan.
Nathan estimated the fund would generate $100 million dollars annually after the initial investment and in addition the state will get $300 million a year since the federal government matches Medicaid spending 3:1.
Permanent funds operate a bit like endowments, according to Nathan, generating a regular funding stream from investments.
Think NM also is recommending New Mexico join interstate compacts as well as reforming the state's medical malpractice system.
FRED NATHAN: The way these compacts work is much like getting a driver's license. You get a driver's license in one state, but then you can drive in the other 49 states, and that's what we're trying to do here with these interstate compacts. And there's 10 major compacts, one for doctors, nurses, dentists, and unfortunately, New Mexico is only a member of one of those 10 compacts. That's the nursing compact. By comparison, our neighbors to the north Colorado, they're in all 10.
The argument that's been made against this in the legislature is that it would interfere with state sovereignty if we joined a compact. For example, in the medical compact for doctors, 40 states have joined, and they're more than willing to sacrifice state sovereignty in favor of getting more doctors to their state.
KUNM: And would something like this also expand telehealth options for patients?
There was a couple in Santa Fe who had a two-year-old son who had a very rare and aggressive form of cancer. They took the child to UNM. UNM said, “We've never seen anything like this before, we're thinking that we might need to amputate your child's hand, and we recommend that you get a second opinion.” They found doctors and specialists in this disease in Michigan and Pennsylvania. Those doctors said, “Bring your child here immediately.” They couldn't because he was getting chemo and couldn't go through the airport. So they said, “Well, can we just do this over the phone, you know, with Facetime?” And those doctors both said, “No, because New Mexico is not a member of the compact, and if we were to advise you, we would be guilty of a fourth degree felony practicing without a license.”
Ultimately, they had to drive to Texas so that they could talk to these doctors in Michigan and Pennsylvania. If we joined the compact, then that couple could have just, from their own living room, talked to these specialists and gotten the medical advice that they needed.
KUNM: I want to pivot to your recommendations on malpractice. I didn’t realize that New Mexico ranks the second highest in the nation for medical malpractice lawsuits. So what are Think’s recommendations when it comes to reforming medical malpractice?
NATHAN: The point of a malpractice system is to make those patients whole. And the first is to cap attorneys' fees. If you look around the country at progressive states like California, New York, Massachusetts, they all cap attorneys fees. These fees are usually done on a contingent fee basis, and if the lawyer is taking 40% it's a zero sum game. The more they take for themselves, the less for patients. And so we want to make sure that more of that money is going to the patient.
A second issue is something called the Patient Compensation Fund. This was created by the legislature in those cases where there's lingering issues that need to be continued to be treated for many years. It was a pay-as-you-go system that as you incurred the medical fees, you would turn them in and you'd be reimbursed for them. However, the Legislature changed that, and even though it's called the Patients compensation fund, what they did is they created a lump sum payment up front, so that the lawyer could take their 40% and they would make an estimate of how long the injured person would live. Well, if the person lived longer than expected, then they don't have the money they need to pay their medical bills toward the end of their lives.
The third issue is punitive damages, and we think instead of showering a windfall on attorneys that some of that money ought to go back to the public, what we would do is future punitive damages, 25% would go to the injured party and their lawyer, 75% would go into a public fund that any hospital or medical practice could apply to to improve their training, to reduce staffing ratios, anything to improve our health care system and to make malpractice rare in New Mexico.
This coverage is made possible by the W.K. Kellogg Foundation and KUNM listeners.
