Comprehensive health care reform. Do our citizens really want change? And if so, will our elected officials exhibit the statesmanship to bring it about?
Legislators at both the state and federal levels are facing this issue.
In Wisconsin, the Democratic-controlled Senate recently included a very comprehensive health care insurance proposal in their version of the state budget. The Republican-controlled Assembly has stated there is no way this package will pass their House.
I chaired a committee that spent the past two years discussing and developing a health care reform plan for Wisconsin. This committee included representatives of large and small business organizations, labor, farmers, senior citizens, the insurance industry and the legislature. The Senate Budget Amendment called "Healthy Wisconsin: Your Choice, Your Plan" draws on the work of this committee and its staff for much of the plan.
The proposal in the Senate version of the budget is an excellent start.
I wish my Republican colleagues would stop trashing the plan and work with the Senate to improve it, adding provisions to increase consumer incentives to make wise decisions about health care and their own lifestyle as it affects health. This would help to further control future increases in health care spending.
Here are the positives of the Healthy Wisconsin Plan:
- Everyone is covered - that is why it is called universal.
- The existing provider networks are maintained - that is why it is different than the Canadian or European models.
- Every family may choose their own provider network - the same as state and many local government employees.
- Your insurance stays with you regardless of whether you change jobs or lose your job.
- The plan is governed by a board of trustees who will contract with the private sector for both administration and health care delivery - this is not a government health care program.
- The funding for the plan is collected from assessments on income and payroll - this makes it fair, administratively simple and verifiable.
- The plan provides affordable, comprehensive health care for every individual and family in Wisconsin not already covered by Medicare, Medicaid/BadgerCare, or in a state institution.
- This plan will reduce state and local government costs by hundreds of millions of dollars. These savings could and should be used for tax reductions at both the state and local level.
Here are my responses to criticisms of the Healthy Wisconsin Plan:
- "It is the largest tax increase in state history." Because the funding for the plan is assessed on payroll, it is collected as a tax. But the naysayers are neglecting to point out that the approximate $15 billion collected for this plan eliminates more than $15 billion currently paid by businesses and consumers in insurance premiums.
- "Families will have to change doctors." Not true. Families will have choices of health care provider networks just like legislators and other government and school employees.
- "This is a government-run program." Not true. This plan is governed by a board of trustees made up of representatives of large and small businesses, labor, education and agriculture with an advisory group from the health care provider community.
- "This plan is a last minute idea with no public scrutiny or input." Not true. Several groups including the committee I chaired have been working on this for over two years. Labor unions, business groups, health care providers, farmer organizations, senior citizen advocates, legislators, and the insurance industry have been part of these discussions. Furthermore, scores of forums, debates and news articles have covered this over the past year.
- "This plan does nothing to control the cost of health care." Not true. The plan includes co-pays and deductibles to discourage inappropriate use of health care. It also provides preventive care with no co-pays and addresses chronic disease management. As I stated earlier, I wish Republicans would work with Democrats to include co-insurance and funded Health Savings Accounts (HSAs) as my committee proposed in our health plan.
- "This plan destroys the practices of health care professionals and their relationship with patients." Not true. Health care professionals will probably not even notice a change except that everyone will now have insurance.
- "This will destroy Wisconsin's economy and drive away employers and jobs." Not true. Most businesses currently providing insurance will see an overall reduction in their health care costs. Businesses not currently providing insurance will incur increased costs but now both the owners and their employees will have affordable health care.
I hope our legislators and governor exhibit statesmanship on this important issue – but that depends on whether our citizens are really ready to tell their elected officials to provide quality and affordable health care for everyone.
Joe Leean is a former businessman and served as a Republican State Senator from Waupaca from 1984-1995. He also served in Republican Gov. Tommy Thompson's administration as Secretary of the Department of Health and Family Services from 1995-2001. Additional information about the Healthy Wisconsin plan is available at www.healthywisconsin.net.
12 Comments
Mr. Leean is an example of the Republicans that helped us to become one of the most heavily taxed states in the country.
Not everyone is covered- teachers are exempt. Apparently we pay about $20,000 in medical benefits per teacher across the state. How about starting to solve the problem by bringing their benefits down to normal levels provided in the private sector and using the vast savings toward helping the 8% uninsured?
Do you expect the government not to mess this up over the long-run? I'll bet the other way. Once the politicians and bureaucrats stick their paws into this pot of money they will want to rule medical care in this state. They will do a wonderful job with health care like the do with the rest of state government- Dept 0f Rev.(soc. sec # fiasco), Dept of Admin. ($50mm computer screw-up), DMV (drone bureaucrats with long lines), DNR (Pier law, Butler snakes, unresponsive dictators), etc. etc.... By the way, who gets fired when they screw-up at these bureucracies? How can you sue them for being unresponsive to the public? Wait for the next election and hope the politicians are responsive? Good luck. It would be easier to get better health care at a lower cost by moving out of state.
As to government solving the health care "problem", approximately 8% of the population is uninsured in Wisconsin. Some of the uninsured are young people that don't want to spend the money on insurance. Why should society pay for these freeloaders? Also, what is the percentage of the population not happy with their health care? Where is the big outcry? Why didn't the Dems and the Rinos like Leean run the last election on the specifics of this goofy plan? If they are saying their program will be more responsive to public demands, then why are they cramming it down our throats without little public debate? Sounds like government as usual.
Please stay retired from politics Mr. Leean.
Thanks to Joe Leean for a sensible analysis of the Healthy Wisconsin plan. If only his Republican colleagues will listen up. If they want to provide business relief and business growth in Wisconsin, this is the way to do it.
Note that the teachers were excluded because, unlike most other jobs in the state, they have a salary cap. Eliminate the cap and perhaps you could argue for their being included.
The rest of Anderson's scare tactics is pure bullsh*t. The physicians will remain in charge of the patient's care, just as they are with Medicare.
For those opposing this, I'd be damned concerned about where healthcare is heading. He who has the gold, rules. And that's the corporations and they are already establishing their own co-op managed care companies. Get ready for corporate medicine, because you won't have another choice in five years. If you think things are bad now, just wait. It is going to get a lot worse.
Even the insurance industry hacks are not going to like the final outcome, but as long as they can delay a sensible fix the profits will continue rolling in.
RE: Jack Lohman,
Most people in the private sector have a cap on earnings (they can't demand huge pay raises without some reasoning), have to work all year long (not 180 days), and don't have extravagant health care benefits. Admit it, because the special interest group WEAC puts big dollars in the democratic party's pockets is really why they are exempt from the "universal" health program. So why if the Dem plan is so great won't the teachers agree to it? Please answer. The complaint I'm hearing about is that big money is influencing health care- isn't that what WEAC is doing?
Also, please answer the question- what percentage of state residents are not satisfied with their health care?
As to physicians remaining in charge of patients care- what is the purpose of this plan if the State is not going to dictate health care services? Do you think the state, controlling all the health care tax monies is just going to hand it over to medical providers without any strings?
As to Anderson's comment about the government messing-up health care, I agree. Who thinks they will be more cost efficient than the private sector? I heard that the state senate already underestimated the cost of this plan!
This plan will hurt small businesses. Especially new ones. Why would someone want to start a new company in Wisconsin with this added 15% tax instead of going to another state that does not have it? In addition, successful small business owners earning more than $50,000 a year would end up paying more for health care than they do now.
Finally, the way this health care bill was passed through the State Senate with little debate and then crammed through in one day is an indication of how government will work for us with health care. Shove whatever plan they have down our throats because they know better. Is that what you call good government?
PS Jack Lohman- are you a member of the Healthy Wisconsin group? If so, why not identify yourself as one? Transparency anyone?
I was not involved and cannot answer your question about the teachers exemption, but will say that I am as unhappy about WEAC's cash to politicians as I am about WMC's cash to politicians. But when you live in a world of political corruption, that's just the way it is. Live with it. Or try to change it as I am trying.
The state is going to set a minimum level of care and then private healthcare providers will provide that care. If you want to characterize that as "dictating" health care, so be it. They are "dictating" is a floor, not a ceiling. Buy what you want to above that minimum.
Who thinks this is going to be more effective than the private sector? It *IS* the private sector. What are you talking about? Besides, why don't you explain why the privatized sector of Medicare (Medicare Advantage) is 20% more costly than regular Medicare, even AFTER they screen in the healthiest and decline the more sickly patients? So much for private being more effective than public services.
Why is it that you Republicans insist on talking about the 10.5% tax on businesses and refuse to accept that it eliminates the 15% they are currently paying in healthcare premiums. This is a decrease!!! Get your calculator out. It is the best thing that could happen to businesses, and I say that as a former CEO that saw 17% per year increases in health care before I sold my company and retired in 2004.
Crammed through at the last minute? Did you not read Leean's answer to that above?
And talk about disclosure? Bill Anderson and Bob Johnson write awfully similar. But assuming they are different people, how about some disclosure on your end. Are you an insurance industry hack (sorry, rep)? A Republican?
You can Google "Jack E. Lohman" and see all the info you need on me, or go to my disclosure page at www.throwtherascalsout.org/disclosure.htm. I have written openly that I am a supporter of the Healthy Wisconsin plan both in the Small Business Times and elsewhere, though I have also written that I would like to see it go farther than it does. But I am not paid by them or anybody else to help get it passed. Are you paid to see it fail?
You can see all my efforts below.
www.ThrowTheRascalsOut.org (political advocacy)
www.BusinessCoalition.net Business Coalition for Single-Payer Healthcare
www.MoneyedPoliticians.com (Book site: "Politicians - Owned and Operated by Corporate America")
www.WiCleanElections.org (Describes the benefits of public funding of campaigns)
www.SmokeFreeDining.net (searchable database for smoke free restaurants)
Please also add:
You can see more on the Healthy Wisconsin plan at http://www.throwtherascalsout.org/healthy_wisconsin.htm
So Jack, why don't you denounce the dems for exempting teachers? The plan has been enacted and could be changed but I don't hear you lobbying to get rid of the exemption.
As to you having sold your company and retiring. Good for you. But how is a small business person to overcome this added expense when competing against somebody in another state without it?
As to this plan not being dropped on the public- When did the dems run on the specifics of this plan- We just had an election and I didn't hear or see in their propaganda that they were going to tax the sin out of us and take over health care.
As a small business person, this plan will cost me at least $10,000. So where is the savings? My wife's job currently covers our insurance. We made a long-term decision several years ago that she would take her job with the insurance. That is one of her benefits that we assume she has (not unlike your argument about the teachers, but her benefits are not rolls royce like the teachers). The dems behind this plan don't care about taxpayers like me. They say tough luck. They are more concerned about spending taxpayer money then they are about the taxpayers.
The corker is that this plan covers illegal aliens! YES-ILLEGAL ALIENS. How can we expect this plan to be run efficiently when they are welcoming non-citizens into the program. The dems will bankrupt us if they can. Just keep feeding the beast.
First, I think the teachers are being used as a scapegoat here. If you can't find legitimate fault, turn the public against the teachers as a way of discrediting Healthy Wisconsin.
Were I to have dealt with it, I would prefer exempting them and moving the bill forward without them included knowing that (a) they are protected until their contract runs out, (b) I would not delay the bill until that later date, and (c) knowing that when the negotiations do begin I can then move them to the public system, which should be damned close to what they now have. And if it isn't, it's the fault of the Republicans for not rallying behind the Miller-Benedict bill, which was stronger than Healthy Wisconsin. It is disingenuous to force a compromise and then fight the compromise because it is not strong enough. Let's get this bill passed and fine tune it later.
Secondly, if you have followed my actions I have been as critical of WEAC money as I have of WMC money, but more than that I am critical at the corrupt political system that both the D's and R's share responsibility for (though 40% to 60% respectively). I am (generally) a center-right Republican, but that carries zero weight with me when it comes to the corruption the R's have perpetuated (with the D's help). We have a payola system that no businessman should be happy with.
You insist on calling this a government run system, or takeover of health care, and you are wrong but apparently don't care if you are wrong. The state only collects the taxes/premiums and passes them to a commission that distributes to the PRIVATELY RUN HEALTH CARE NETWORKS!
This bill has developed over the last several years and hearings have been held all over the state. Sorry you were sleeping.
Ah, so now we have it. You have offloaded your insurance responsibilities to your wife's company and THEY enjoy the expenses instead of you, and you like that just fine. That may make THEM less competitive in the marketplace, but you are okay with that. I see. That must be what the right-wingers call "personal responsibility."
And please, don't give me this "Dems don't care about taxpayers" crap. We are coming off of a Republican-run generation where the R's gave away half of the state's assets so they could collect campaign contributions. Our deficit was caused by THEM, and though I'd rather see reductions in spending to raised taxes, we still have a moneyed political system that controls spending.
And look, we are ALREADY pay for illegal aliens when they show up at the emergency room, and will I agree that the immigration issue must be dealt with, but separately. Refusing them health care is not the way the truly "compassionate" would have us deal with it. As long as their taxes are going into the system they should also receive care. Kick them out of the country if you wish, but while they are here the humane among us say "give them care."
And please, quit using these fake names.
I would like someone in favor of this plan to explain to us what will happen to wages in this state if this Health Care plan would get enacted. If an employer is taxed based on the wage of the employee, that gives the business an incentive to hold wages back…specifically if the tax is tied to the wage of the employee…follow the math…lets say a company gets taxed 15% of the employee's wages…it comes raise time…the business budgets 5% for wage increases…will they hand out a 5% wage increase to John Q. Lunchbox and pay the extra 15% of that increase in new taxes, nope…the business will give the employee a lower raise and take the rest of the money budgeted to help pay the tax…so this so-called free healthcare is going to cost more and more every year paid for indirectly by the employee…does this help or hurt middle class and poor families?
Following is a clarification sent to me by someone closer to the Healthy Wisconsin details than I. Of great importance is the fact that the teachers are NOT exempted, and as one employer saving much under this plan,HALF of the savings will go back to the taxpayers and result in a decrease of about $500 million in property taxes.
I post this knowing full well that some on this blog are insurance company representatives trying their best to distort the hell out of the proposal. Readers will have to assess for themselves who to believe.
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One of the silly myths about Healthy Wisconsin that's circulating in the blogosophere and elsewhere is that teachers are exempt. That is untrue. Teachers are treated like all Wisconsinites. Their benefits under Healthy Wisconsin are the same as everyone else's. They pay the same assessment as everyone else. Their employers (school boards) pay the same assessment as all other employers.
How did this silly myth that teachers are exempt come about? I believe it's because of a technical provision, inserted at the suggestion of the non-partisan Legislative Reference Bureau, that seeks to harmonize the provisions of Healthy Wisconsin with the provisions of the existing QEO (Qualified Economic Offer) law.
I'm not an expert on the QEO law. But I believe that all the technical provision does is provide that, in interpreting an existing QEO requirement that teachers' existing health benefits must be maintained if a QEO is imposed at the end of the collective bargaining process, the meaning of "maintaining existing health benefits" once Healthy Wisconsin takes effect shall be the sum of the often lesser Healthy Wisconsin benefit package plus whatever supplemental benefits are needed to add up to existing benefits.
This is a complicated provision. It's understandable that some people have misunderstood. Regrettably, others who know better seem to have intentionally twisted its meaning to try to score debating points.
But the bottom line is that Healthy Wisconsin doesn't exempt teachers from anything. To continue to claim that teachers are exempt from Healthy Wisconsin is to distort the truth.
This distortion is just one of many that's circulating. The more serious distortion about the plan that's floating is that Healthy Wisconsin will raise taxes.
The fact is that the Heatlhy Wisconsin $15 billion assessment would automatically result in the elimination of far MORE than $15 billion in current spending by individuals and employers. As a result, the independent Lewin Group has concluded that, under Healthy Wisconsin: (1) total spending on health care will decline, mostly due to administrative savings; (2) families will save money; (3) employers as a whole will save money; and (4) currently insuring private firms will save money.
Because governments (in their capacity as employers) save so much money, Healthy Wisconsin requires that half of government's savings be returned to the taxpayers in the form of a massive property tax cut. This tax cut will exceed $500 million. It will result in the second biggest statewide cut in property taxes in recent Wisconsin history. This reduction in property taxes is so large that people's tax bills will actually go down.
Reasonable people can certainly argue about the merits of Healthy Wisconsin. But noone should get away with distorting the facts about it.
Everyone covered by Healthy Wisconsin will have health insurance as long as they live in our state. They will remain insured regardless of their health condition, employment status, or family status. Only if they move into another health insurance program--such as Medicaid, BadgerCare, or Medicare--will Healthy Wisconsin stop covering them.
Healthy Wisconsin lets people select the health care network they want--and choose the doctor they want. It puts us in control. We get to keep our doctors, even if we lose our jobs or change employment.
Costs will be primarily controlled by getting the incentives right (for the first time in the history) and through competition among private organizations to lower prices and improve quality. For the first time, market principles--such as consumers having choices, and health care providers having strong incentives to become more efficient, lower prices, and improve the quality of their services--will truly apply.
Healthy Wisconsin will dramatically reduce the number of uninsured--from 476,000 to 15,000, which means from 9% of Wisconsin's population to under half a percent. Wisconsin will be the nation's leader, by far, in having the smallest percentage of uninsured.
Health spending will decline.
Families' average health costs will decline.
Employers average health costs will decline.
Private employers who now provide insurance will on average see savings.
And all of us who pay property taxes will see our property tax bill go down. Households will see a property tax cut. Businesses will see a property tax cut.
Yes, Randy, let's DO follow the math. Since 2000 medical costs have increased at 5% per year but insurance premiums increased a total of 87%. Just what do you expect that your employer is going to do now? Health care premiums are going up a hell of lot faster than wages. Your employer may not even remain in business, or may send his jobs to another country, if we don't fix the system today. Look at the growth in the chart linked below and then ask: Do I really want 31% of health care dollars going to an industry that is just skimming profits at my employer's expense?
http://www.throwtherascalsout.org/UnitedHealthGroup.gif
Here is my criticism of Leean's proposal
to help enact Universal Health Care in
Wisconsin. The following is a letter to
the editor published in the Cumberland
Advocate of Cumberland, Wisconsin:
Certainties: Death and taxes…and universal health care?
In the 80s film, Top Gun, starring Tom Cruise, Cruise's character, Maverick, is reprimanded for wasting a "taxpayer's missile." Maverick, while a likeable character, is too much of a "loose cannon." But even though he pays little mind to the taxpayers funding his military exploits, we tend to feel sympathetic to his individualistic disregard for the naval chain-of-command. One wonders if, Joe Leean, advocate of universal health care in Wisconsin has a similar disregard for the taxpayer (see Cumberland Advocate, Wednesday, July 25, 2007). Is he, like Maverick, a "loose cannon" with good intentions for the health of Wisconsinites or is he the victim the latest medical propaganda that to be healthy all Wisconsinites need health care?
First, I'd like to rebut Joe Leann's arguments for universal health care in Wisconsin. Then I'll review some objections that he doesn't consider important. Mr. Leann does not provide any evidence that having medical insurance ensures greater health. In fact, one could well make the opposing argument that having medical insurance encourages families to take the "band-aid" approach: don't fix the problem at its roots but treat the symptoms. That's not creating a healthier Wisconsin!
Leann would have us believe that a program is not "government-run" if it is "governed by a board of trustees." I'm sorry but I think that most Wisconsinites would beg to differ on this point. If a program is administered at the payroll level and is backed by government sanctions against employer/employee non-compliance, then it is "government-run." How Leann thinks that he can dance around that fact is truly amazing!
Employees who pay high insurance premiums still have the choice of dropping out of employer-sponsored health care plans and opting for alternative medical treatments (such as St. John's Wort instead of Prozac). Similarly, employers can drop sponsorship of inefficient health insurance companies and give employees vouchers for the above-mentioned alternative treatments. Wow, now that's "fair, administratively simple and verifiable" to use Leann's language and it saves $15 billion dollars in taxation that is not really "government-run"!?!
Objection not considered by Leann: What happens when a new tax added to both employers and employees leads both to expect "benefits" that were not needed before? We can blame government for trying to control our health when there's a longer waiting list at the local clinic than there was before universal health care was imposed. We can blame a government program that's not really "government-run."
How about those who judiciously avoid too many hospital visits and administer chicken soup instead of legalized drugs for the common cold? Will they be rewarded by receiving a tax credit for all that they paid into the government pot? Will that still be "fair, administratively simple and verifiable"?
Finally, a Republican politician that puts the good of the people before the corporate greed of the health insurance dinosaur. If we are going to cover everyone, why not use the health insurance industry take to actually provide health care in a method similar to Medicare for everyone. It is slow going but if you are a fiscally responsible Republican, please visit www.RepublicansForSinglePayer.com