State Rep. Pete Jorgensen, a Democrat seeking re-election to the House District 16 seat, and Republican challenger Joe Schloss agree that access to quality, affordable health care is one of the biggest issues facing the state and one of their top priorities.

They also agree that with only one major health-insurance provider and a documented shortage of doctors, the state’s health-care situation is not as good as it should be.

They don’t agree on much beyond that.

Jorgensen said he would like the state to expand existing benefits programs to include more Wyoming families. Schloss said the state needs to provide more incentives to insurance companies.

Jorgensen said the state could offer immediate relief by fully funding existing programs like Medicare and Medicaid and raising the income limits on those programs so they cover more people.

“That is appropriate because those programs only apply to the poor and those over 65,” he said.

He said more doctors could be enticed to do business in Wyoming if the state upped its reimbursements to health-care providers under those programs, which currently cover only 40 percent to 80 percent of a procedure. Jorgensen pointed out that funding for those programs is matched by the federal government so it would leverage the state’s dollars.

Access to quality primary care could be greatly increased if the state participated more in a state-federal partnership to build community health centers, he said. Construction and staff for centers would again be split between the state and federal governments. Such centers would provide preventive and basic care and could refer patients with more serious ailments to specialists in bigger cities. Wyoming currently has four such centers, while Colorado has more than 60, Jorgensen said.

Besides more funding, Jorgensen said, the state needs to give more power to the state insurance commissioner, who is tasked with overseeing the insurance industry in Wyoming. Currently, the position does not have enough power to investigate if rates charged to customers are fair or intervene in complaints of unfair rates, Jorgensen said.

Jorgensen discounted free-market approaches, including offering tax breaks to attract insurance providers, saying they wanted to insure only a certain segment of the population.

“We are not talking about the ones they want to insure anyway,” he said. “They don’t want to insure the poor.”

Ultimately, Jorgensen said, he would like the state or federal government to set up a health-care system, but he didn’t think such a proposal had support in Wyoming.

“The fact that we are the only industrial country without a single-payer health plan should be a lesson to us,” he said.

Schloss said the key to lowering costs and increasing care options is to encourage more market competition by offering incentives to heath-care providers and health-insurance companies to do business in Wyoming.

One way to do that could be with tax cuts, he said. More importantly, the state needs to expand the customer base it can offer insurance companies by joining together with other states and allowing insurance companies to operate across state lines.

“I believe we need to join with adjoining states and offer a tristate program,” he said. “With a half-million people, at this point [insurance companies] are just laughing at us.”

Schloss suggested combining Wyoming with Idaho, which has about 1.5 million people, and Montana, which has about 1 million people, to offer a pool of 3 million people to prospective insurers. Details of the agreement would have to be finalized by governors of the respective states or, Schloss said, perhaps one of the states would have an existing program that Wyoming could join immediately.

Schloss said he opposed any effort by the state and federal government to implement a health-insurance system for all residents.

“I am not in favor of the government running the program,” he said. “I am not against the state and federal government offering incentives to bring in the insurance providers we need.”

Schloss also said the state needs to implement caps on medical malpractice suits to attract more doctors.

“We have no caps in Wyoming, and consequently doctors young and old are reluctant to come to Wyoming because they can be sued for unlimited amounts of money,” he said. “The best way to attract doctors is to put reasonable, responsible caps on tort awards.”

That was one other area the candidates agreed upon, with Jorgensen saying tort reform was absolutely necessary before any cooperation between states because all the states neighboring Wyoming have some form of medical malpractice liability caps.

One measure that would have done that was proposed in 2004 as an amendment to the Wyoming Constitution. It was narrowly defeated in the November general election that year after opposition from trial lawyers, including Jackson’s famed Gerry Spence.