Panelists offer plans for health care reform
The conflict seemed to be between a moral obligation to provide timely affordable health care to all Wisconsin residents and the fear that those who already have excellent medical care might lose it or their control over access.
During a presentation in River Falls last Thursday evening, two retired physicians, a legislative coordinator for the AFL-CIO and a former Wisconsin state budget director outlined three universal health care proposals promoted by various state lawmakers.
Audience comments came from a UW-River Falls employee who cautioned that assuring coverage to people who go to Minnesota for medical care could be a problem and from a 3M retiree concerned about preserving benefits offered by good insurance plans.
"These three bills are different, but every one is better than what we have now," said Dr. Gene Farley, former UW-Madison Medical School chairman of family medicine. "Our job is to let everybody know there's something out there."
About 500,000 Wisconsin residents have no coverage, said Farley. He said illnesses and medical costs are the major cause of bankruptcy in the United States and over 18,300 adults die each year because they don't have insurance.
"This is unheard of in any other nation," said Farley.
There are about 700 health insurance companies doing business in Wisconsin and from 1970 to 1996 the number of health administrators grew more than 20 fold, according to the Coalition for Wisconsin Health.
Farley said Americans pay more in taxes for health than do citizens of other countries, but U.S. tax-supported programs -- which include Medicaid, Medicare and insurance for government employees -- cover only 45% of Americans.
Thirty-one percent of health costs in the U.S. are related to administration and that money would be better used providing actual care, said Farley.
"It will only happen if you, the people, insist upon it," he said.
Wisconsin Health Plan
Panelist David Riemer, who served as Milwaukee's director of administration for a decade and was Gov. Jim Doyle's budget director in 2002-03, presented the "Wisconsin Health Plan."
He said the plan, an attempt at a bipartisan solution to the problem, aims to provide health insurance for all the state's residents, reduce costs and offer fair financing for employers and provide a "big tax cut" for Wisconsin homeowners and businesses.
Under the plan, said Riemer, everyone would have the security of knowing that if they have to go to the doctor, they won't end up with a huge bill. Also, he said, employers would know that their health care costs wouldn't have to increase two, three or even four times the rate of wage growth.
"It's virtually universal coverage," summarized Riemer. He said there would be predictable assessments and every person and employer would pay a fair share.
Under this plan, said Riemer, insurance companies would continue to offer polices, but the variety of policies would be cut since most residents under 65 would have a uniform benefits package. Companies could offer supplemental policies.
Health Care Partnership
Wisconsin's current health insurance system is "costly, dysfunctional and unfair," said panelist Steven Williams, speaking for the AFL-CIO-sponsored Wisconsin Health Care Partnership Plan.
It's reached the point where workers are negotiating to keep their health benefits because they have become so expensive for employers, said Williams.
Under the partnership plan, there would be one health insurance plan in the state and the administrator would collect employer fees and pay claims. Bureaucratic insurance costs would be greatly reduced, said Williams.
He said self-employed persons, farmers and early retirees could buy in at costs estimated at $340 per month for family coverage and $170 a month for single coverage.
Health Security Act
"We believe the market place belongs in lots of places, but not in health care," said Dr. Linda Farley, outlining the Wisconsin Health Security Act, a single-payer plan. She said much of the problems in U.S. health care can be traced back to "market-driven, investor-owned" insurance companies.
When she became a doctor, medical care was considered a service, but it has become "a business run by the business office," said Farley.
She said the Health Security Act would be government funded but not government run. The proposal would "get rid of" all for-profit ownership in the health care area.
The program would work something like Medicare, said Farley. She said Medicare overhead costs are about 3% while overhead costs for investor-owned medical facilities are 26.5%.
Health care is something -- like roads and police protection -- that everyone needs but can't provide on their own, said Farley.
"It's going to be up to the people to demand that (reform) happen," she concluded.
With limited time for comments, there were only a few.
A UW-River Falls employee said the while western Wisconsin residents get their basic health care here, they go to Minnesota for specialized care. It's important that any state-wide coverage plan address that, she said.
The panelist said their proposals are still being developed.
The proposed $340 a month cost won't cover the health care coverage she has been getting for the last few years, said Barbara Peterson, a 3M employee who took early retirement and is still under the company's plan.
"While I'm retired, I'm in the lap of luxury in terms of health care," said Peterson. "You're going to take it away from me?"
She said she, and not a panel or commission, decided when the pain was bad enough that she needed knee replacement surgery.
Gene Farley replied that without administration costs, health care will be much less expensive.
In a given year 10% of people account for 70% of the use of medical care, said Linda Farley, implying that pooled funding will cover the needs in any year. She also pointed out that the $340 cost was confirmed by an outside analysis.
Last week's forum was one of several being held around the state by the Wisconsin Council of Churches. About 20 people attended.
Source: Wisconsin Council of Churches
How they would work:
Wisconsin Health Security Act
Administration: A publicly funded program administered by the Department of Health Planning and Finance under the guidance of the Wisconsin Health Policy Board.
Coverage: All Wisconsin residents regardless of pre-existing health condition, age, geographic location or employment.
Funding: Public funds already spent for health care, taxes on employers and individuals, savings from reduction of paperwork streamlined administration and cost controls.
Health Care Partnership
Administration: A labor-management commission will develop the details of the plan, solicit bids to administer the plan, set reimbursement rates for hospitals and medical providers with incentives for quality measures, adjust employer-paid monthly assessments and employee co-pays and deductibles as needed, and make changes in plan benefits and financing as needed.
Coverage: All private and public sector employees and their dependents in the state. Self-employed workers, farmers and early retirees could purchase the same insurance at cost through a separate community-rated pool.
Funding: Costs will be split between employers and employees. Employers in both the private and public sectors will pay a flat fee per employee per month. Employees will be responsible for deductibles and co-pays.
Wisconsin Health Plan
Administration: The program would be administered by the Private Health Insurance Purchasing Corporation of Wisconsin, a private corporation governed by an eight-person board of directors. Board members include two gubernatorial appointees and one representative from each of six labor or business groups.
Coverage: All Wisconsin residents less than 65 years of age except people who have lived here less than six months, claim residency elsewhere for tax purposes, are institutionalized, are employees of the federal government or are eligible for Medicaid or BadgerCare. Participants would receive a "premium credit" to purchase health insurance from competing, qualifying health insurance plans. Adults would receive an HSA of $500 a year.
Funding: Each employee would pay 2% of his or her Social Security wages. Each employer would pay a percentage of their total Social Security wage. That percentage would range from 3% to 12% depending upon size of payroll. Deductibles and co-pays would be capped at $500 for children, $2,000 for single adults and $3,000 for families.
For more details on these three proposals, go to these Web sites: