The Wisconsin Legislature is poised to make the fundamental changes needed to address Wisconsin's health care crisis.
We are responding to the middle class families and small business owners who have been asking for dramatic action to address our state's health care crisis. At countless meetings around the state we heard from business owners who are struggling to afford health care for themselves and their employees. People like the owner of a small manufacturing firm in my district in Bay View, who is spending more than 20 percent of his payroll on health care, and people like the owner of a small business in downtown Eau Claire whose health care premiums rose 27 percent last year, 7.5 percent the year before that and 15 percent the year before that.
Based on what we heard from citizens across our state, legislators created a plan (known as Healthy Wisconsin) that will provide every Wisconsin citizen with their choice of doctor, their choice of provider, and will cover people regardless of pre-existing conditions or job status. It gives people the power to follow their dreams, whether it's getting a job they've always wanted, or whether they want to start a new business on their own.
The plan is paid for with an assessment that replaces what companies currently pay for health insurance. Employers will pay 10.5 percent of Social Security wages and employees will pay 4 percent of Social Security wages. Sole proprietors will pay 10 percent of Social Security wages.
The nationally-respected Lewin Group analyzed our proposal and found these changes will save most companies money, especially those companies already providing insurance to their employees. The savings are greatest, on average, for companies with 10 or fewer employees who already provide insurance. Lewin estimates that local governments will save $1.3 billion under the plan – savings that make property tax relief for property owners and businesses possible.
People have proposed a state deduction for Health Savings Accounts and improved transparency as stand alone solutions to our health care crisis. By themselves, they are not a solution. The average Wisconsin has a family income of roughly $40,000. It is asking too much for a family already struggling to afford groceries and gasoline to save enough money to fill a Health Savings Account and have that be the only way to get health care. Transparency, on the other hand, is already part of the initiative we are proposing and is a worthwhile initiative. But knowing how much a procedure costs is not the same as having the ability to pay for that procedure.
In the coming weeks we will be debating different approaches to health care in the legislature. I hope that both sides of the aisle can come together to make access to quality, affordable health care a reality for more middle class families. Working together we can make this dramatic and positive change in Wisconsin's health care system.
State Rep. Jon Richards (D-Milwaukee) represents the 19th District in the state Assembly and is the assistant minority leader.
15 Comments
Healthy Wisconsin will drive small employers out of business. Only some 50% of small employers are able to afford any health insurance plans for employees today. Dropping an additional 10.5% to 12.0% (the range specified in the plan) cost on these employers' bottom lines will likely drive more of them out of business, will cause more that provide coverage to drop that coverage and we'll ultimately have more uninsureds than we do today. The Healthy Wisconsin program is written to permit up to a 12% annual increase in costs and assumes that there'll be huge savings derived by the use of a few managed care networks. Whenever a cap is set, it becomes the ceiling thus nearly assuring that costs will rise at that rate annually. By the end of the fifth year of this plan, the cost to employers could have risen to more than 21% of payroll. This plan does nothing to address the real issues: the cost of health care is out of control and the covered person has no ability to make judgements as to cost efficiency and quality of outcomes since that is not sufficiently transparent. The free marketplace can control this far better than the government if the government will do its portion of the heavy-lifting by passing tax cuts for consumer driven health plans and by causing the sharing of cost and outcomes data. Healthy Wisconsin will sufficiently alter the provider/insurer landscape if passed, and will assure that we have no real recourse several years down the road if we need to reassess that program. We'll have been saddled with a Canada-style solution that, in spite of Michael Moore's protestations, will result in rationing and a generally poorer level of care. True, everyone will be assured of health care, but they'll have to wait weeks and months to obtain it...if they're still alive.
Let me tell you how government run "free" health care works now.
My son has a spiral fracture of the tibia from a bike accident. We go to children's hospital where they are going to set and cast the fracture. My wife and I strike up a conversation with the staff who actually does the casting. We discover that many parents who have "free" health care let their kids go to waterparks and pools. Then they come in and get a new cast, free. The parents are told not to get the cast wet.
This was 4 years ago, and now I see waterproof casts, so maybe this issue does not occur anymore, but the underlying problem will still be there. If you don't have to pay for your care out of pocket, you will use more medical services. After all, its already paid for, so you may as well use it.
The responsible citizens will have to pay for the irresponsible. The healthy will have to subsidize the unhealthy lifestyles of alcoholics, drug abusers and the obese. These are all personal lifestyle choices. I am not in the mood to pay for the medical bills of some underemployed slacker who breaks his leg in 3 places trying to skateboard down a railing.
When government comes to you and says they will take over, improve efficiency and save money, you would need to be an idiot to think it could be true. Or you would need to be a politician. Oops, I repeat myself.
Rep. Richards is lying when he states "every Wisconsin citizen" will be covered by his plan. Public school teachers are exempt. Why? Because they spend loads of money electing democrats like Richards. Also, Richards doesn't tell you Wisconsin spends $20,000 per teacher for health care, which is way over what the private sector pays. But Richards wants we mere serf/taxpayers to keep paying for the teacher's Rolls Royce plan while we serfs are left with the second class health care plan. Why not take the money that we overspend on teachers and put it toward helping the uninsured? Because teachers are special according to supporters of the unHealthy Wis. Economy plan.
Did Richards mention that beside citizens the plan covers illegal aliens? Yeah, ILLEGAL ALIENS! So Richards wants all us serf/taxpayers to keep feeding the Wisconsin beast. More government, more taxes, more government, more taxes...
Alan, you seem not to have studied the facts. Businesses are already spending 15% of wages on health care. Healthy Wisconsin drops that to 10.5% of wages, a savings that will allow them to keep the doors open, jobs in Wisconsin, and it will attract new businesses to the state. It'll also allow entrepreneurs to start new businesses because health care was the one issue that kept them from doing so earlier.
Alan believes that the free market is the way to go. But we've had that for a decade and that's what has gotten us to today's crisis, with an increase of 87% in premiums since 2000. And this so-called transparency -- which may work with quality tracking but not pricing -- will take a decade to put in place. But people will not seek out the lowest bidder, as the reverse will likely occur when the health of a loved one is in play.
But the database development for transparency can (and should) go on simultaneous with the Healthy Wisconsin fixes. Finally, the scare words of "rationing" and "wait times" are inappropriate in a country that spends 50% more than Canada and double other countries' expenditures.
And Art, the "responsible versus irresponsible" argument will go on for centuries. But there are health issues that even the responsible cannot avoid. Healthy Wisconsin is designed to alter the way we pay for health care, not to alter health care itself. It's savings comes from substantially reducing the 31% in administrative waste.
If I had my druthers we would switch to a complete Medicare-for-all system, which even the health care networks could enjoy. But this is a reasonable compromise that should be passed by the republican assembly. I refer you to Joe Leean's article at
www.biztimes.com/blogs/milwaukee-biz-blog/2007/07/05/republicans-should-quit-obstructing-health-care-reform
You can also see my disclosure at www.throwtherascalsout.org/disclosure.htm
And my article on Healthy Wisconsin at
www.throwtherascalsout.org/healthy_wisconsin.htm
And to "Bob Johnson," who has posted under several other names on this and other blogs, please get this straight: WE ALREADY ARE paying for illegal aliens when they show up at the emergency room! Even if we continue paying for them it is a drop in the bucket compared to the costs of the massive insurance bureaucracy Healthy Wisconsin will replace.
Unless you are an insurance industry hack, this is the best thing that could happen to the Wisconsin public and to the businesses we want to retain. My compliments to Rep. Jon Richards and Sen. Joe Lean for their efforts to solve this massive industry ripoff.
RE: Jack Lohman
So is this how you would manage your plan? Give more benefits to illegal aliens? Nice way to start keeping a cap on costs. LOL
How about flying in people from other countries when they need medical care? Its only serf/taxpayer money!
Could you answer these questions:
1. What is the percentage of residents in the state that are not satisfied with their health care?
2. Why should the teachers be exempt if this plan is "universal"?
3. Why if this plan is so great do the teachers not want to participate?
4. When did the dems specifically run on this huge tax and government medical takeover plan?
Still waiting for good answers, instead of excuses.
As to ripoffs- How about the forced, massive ripoff by our state government? Basically what you, Leean, Richards, and the rest of the dems are socialists. You will tax, regulate, and dictate the life out of we mere serf/taxpayers and are willing to sacrifice us to your Wisconsin beast.
As to government replacing massive bureaucracies in the health care industry- Thats almost funny if were not so absurd. Yeah, those guys at the DMV and the post office sure now how to run things efficiently.
PS. Jack, I'm a dog.
Please, get off that kick. You're talking about perhaps a 1% cost difference when you consider what we are already paying for the illegals. And the new plan could even be cheaper. Find a REAL issue.
Oh, you have. Now it's flying people in from other countries. I suppose if they can establish the one year residency requirement they will have just beaten the system. Clearly there must be other rediculous scenarios you can come up with.
1) Are not satisfied with their (a) health care or (b) their health care costs? The answers are (a) for those with employer insurance with reasonable co-pays, few are unhappy. But few any more have that. many are either uninsured, underinsured, have an HMO or managed care system that avoids care, or HSAs that require high co-pays. And (b) virtually 100% are unhappy with the exorbitant health care costs (except those in the insurance industry, who love them).
2) I stated this on the other blog but will again: Were I to have dealt with it, I would have also exempted the teachers and moved the bill forward knowing that (a) they are protected anyway until their contract runs out, (b) delaying this bill until that later date is not necessary and is unwise, and (c) knowing that when the teacher's negotiations do begin I can then move them into 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 either not strong enough or too strong. This IS a compromise and a very workable one at that.
3) Redundant
4) Stupid
You just don't get it. The government is not going to RUN the system, the private networks and clinics and hospitals will run the system. The government will only fund it, just like the do the Medicare system, and that has worked just fine for 50 years.
And so, you really are a dog? Which insurance companies are hiring dogs nowadays?
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?
Yeah, 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
RE: Jack Lohman
As to illegal aliens- this is typical of the dems/socialists- You say you will be cost efficient and then you turn around and give services to non-citizens. I don't care if its .01%, its just indicative of the way your plan will be managed. You and your like are happy to blow taxpayer/serf money on nearly anything.
1.If you had some study showing a high percentage of the population was dissatisfied with their health care you would tell us about it. As far as medical care costs are concerned- sure I'm not happy with its high cost, but I'm not crazy enough to think the government could manage health care more efficiently than the private sector. Please name a service where both the private sector and government compete, where the government provides the service more efficiently. Education- no, delivery services-no, garbage pick-up- no,mmm?
2. Your health plan could include a sunset plan for the teacher's current rolls royce plan. Sure blame the Republicans because the dems/socialists are giving special consideration to a special interest that donates large sums of money to them. Is that in throwtherascalsout?
3. Yeah, I know- your plan is a second class plan compared to what the teachers get. Who cares- we are only taxpayers/serfs.
4. Stupid-you're right. Its obvious they didn't run on this mega-tax plan, health care takeover because they knew few people would support it. Typical dems/socialists strategy run middle-right, govern left.
Finally, Jack I don't work for an insurance company or the health care business. I'm an ordinary taxpayer/serf just trying to keep a few of my hard-earned dollars to provide my family with a better life. I've got a small business with three employees. I work 60-70 hours a week. This health plan, if passed, would possibly be the straw that breaks the camel's back and cause me to move to a state that is not intent on sucking every last penny out of my pockets.
PS- The dog remark went over your head (see the New Yorker).
You seem never to get it: WE ALREADY ARE paying for illegals, and under this plan they and their employers will be contributing where they are not now. That's a plus in my book, but you read it as a negative. So be it.
Name a service where competition exists between public and privates? How about …. get this …. MEDICARE! If you don't think government can handle patient care better than the privates, take a look at the relationship between Medicare and Medicare Advantage HMOs, where the private version is 20% more costly than the public version, even AFTER cherry-picking the healthiest of the seniors. So much for private industry being more cost-efficient than the government.
Look, Bob or Joe or whatever name you are going by today, the Republicans are just as pure/corrupt as the Democrats are, and in my book they ought to all be thrown out and let's start with a clean slate. And if you really want to know where the public stands on this issue, poll them!!! They support a single-payers system hands down, and your "I've got mine" crowd loses the vote.
And if you ARE a small employer you are likely not providing employee insurance, because if you were this would decrease your costs from 15% of wages to 10.5%. So go ahead and move.
At least us "socialists/Dems," if that's what you want to call me, have the balls to use their real names and attempt an intelligent discussion. And we have the compassion the R's claimed to have but don't seem to.
Bob and Jack,
Clearly you two won't change each other's minds, so enough already. Jack, you've proved you are an idiot by thinking that state government intervention will make things better. Bob, no reason to waste your time trying to convince him otherwise.
There are a few sectors of the health care marketplace that have been decreasing in cost over the past few years. Look at LASIK eye surgery and many cosmetic proceedures. They have actually come down in price.
The doctors performing these surgeries are also well compensated.
How has the price of dental proceedures tracked compared to health care? Since a lot of people still pay for the dentist out of their own pocket, dental bills haven't gone up as much as health care either.
If you want to reduce health care cost, don't hide the price in insurance that you force everyone to take. Let people decide if they want a comprehensive plan or a high deductible plan, or something in between. When people start to use health care like they use a dentist or LASIK surgeon, the price will come down and competition will drive the quality up. And some people will be left on a fallback government plan of last resort, which will suck(as a plan and from a level of care standpoint), and suck for them.
Illegal aliens have a great plan: Show up at the emergency room, get treatment, leave without paying. I might go for that one, except the hospital would probably go after my assets and future income.
There is a long term issue to creating a government plan as well. Good doctors will leave for areas where they can be more properly compensated. Eventually, government will attempt to control the charges and compensation of the providers. No one wants to spend all that time in college working hard to get to med school, and then working hard to get through med school, and residency , internship etc. if they are going to end up paid at the whim of some government hack. They may as well drink their way through college and get a poli sci degree like I did.
There are so many things wrong with proposals like Healthy Wisconsin on a macro level it is hard to even start to go into them. And most people who propose stuff like this are too stupid to understand the problems that will result to begin with.
Just give me and my company an opt out provision, and give the health care providers and opt out provision as well. Either in or out, of the government plan. Now that would be a neat experiment.
Jack,
I'm glad you admit to being a dem/socialist- please stop advertising as a Republican.
Do you mean the Medicare with the huge looming deficit and the Medicare with low reimbursement levels that shift costs to private payers? That Medicare?
As to the illegals- at 1% that amounts to $150 million per year. Is that how much we are currently spending on them? If this is such a crisis how about using the incremental difference in money for citizens? But I suppose based on your sound fiscal conservatism under you plan, who cares? I'm proud of you to be so compassionate with other people's money.
As to telling me to leave, as I said earlier, the dems/socialists are more concerned about spending money than they are about the taxpayers. As to the "I've got mine" crowd, what group are you in the "give me yours under the threat of imprisonment" crowd?
Yes I am an employer not providing health care benefits. I have students working for me that have chosen on their own free will to work under terms mutually agreeable between us. Not with somebody like you sticking your nose into my business.
Finally, learn how to debate- responding by saying I should do my own poll and I should leave if I don't like it are arguments at the junior high level.
No more debating Jack, I've wasted enough time arguing with you.
The dog.
More Bushie stuff. If you don't support the current regime of corrupt Republicans you must be a Commie!
I see. But I voted for Bush twice (regrettably), so I don't know where that puts me. But you call me anything you want.
Medicare spends more dollars per patient than private insurers because they almost exclusively cover the more expensive seniors and end-of-lifers the privates refuse to accept. And the $780 billion Part D drug giveaway was designed exclusively to do two things: Repay the drug industry for its massive campaign contributions and cause Medicare to implode so they can move it to the private sector (which is already 20% higher than Medicare). But fold in everybody and the average for Medicare goes below what we are spending today.
So you don't provide insurance to your workers? I suppose they just show up at the emergency room with the illegals when they need care. That's called offloading your responsibilities as an employer, at least as the system stands today.
And though I don't support the burden being put on employers, that's the way it is today. It should be taxpayer funded, just like the fire, police, state patrol, and etc. Only then will corporations be able to compete with foreign companies.
Here is some background I prepared for a Healthy Wisconsin forum Aug. 14 sponsored by the Alliance, the Wisconsin Counties Association and the League of Wisconsin Municipalities.
First, we need baseline data. The most entertaining place to get that is to see "Sicko," the Michael Moore ("Roger and Me," "Bowling for Columbine," "Fahrenheit 9/11" etc.) film about the ailments of the health care system in this country. Folks with a scalpel to grind do sometimes say bad things about it. Shoot the messenger, then haul him off to the ER.
An odyssey through health care in the U.S., Canada, Great Britain, France and Cuba, "Sicko" begins with the plight of the uninsured in the U.S. It shows an uninsured guy who did something stupid with a table saw, cutting off the tips of two fingers. He packed the fingers in ice and headed to the hospital, where he was told reattaching one of the fingers would cost $12,000, and reattaching the other would cost $60,000. He figured he could afford $12,000, but not $60,000. Later Michael Moore found a guy in Canada who sliced off four fingers and had them promptly attached by the Canadian health-care system.
Moore then explores the plight of the insured. In this country, the movie points out, when you need health insurance you can't get it. It's the old story of insurance companies not insuring burning buildings, except in "Sicko," it's insurance companies unwilling to save the lives of children, etc.
Moore found a Madison woman, Becky Malke, identified only by name in Sicko, who cried over the people she met as she took their health histories, knowing they would be denied the coverage they sorely need. Bill Lueders of Isthmus interviewed her, in a story here:
http://www.thedailypage.com/isthmus/article.php?article=8087
Moore crosses our northern border, where he meets Canadians who won't travel to the U.S. because they'll lose their health coverage, and Americans who seek romance in Canada so they can marry into the Canadian system.
See: http://www.hook-a-canuck.com/
Then Moore travels to Great Britain, where he meets a doctor who drives an Audi and doesn't feel underprivileged or underpaid working in a government-run health-care system.
In France, Moore finds a doctor in the French health-care system who makes house calls — that's basically his job — and a pregnant woman who receives six months of maternity leave when she has her baby, and a government-provided home care aide to cook meals and do laundry.
In the next clip, Moore is carrying his laundry basket up the steps of the U.S. Capitol, but — alas — he can't find anyone there willing to do his laundry. Of course, who would want to do Michael Moore's laundry?
Moore then glommed onto a bunch of 9/11 rescue workers who volunteered in the recovery effort after the World Trade Center was destroyed. They suffer health consequences, but lacked coverage on 9/11. Surely Uncle Sam would take care of them, Moore thought. Ha!
So More put them on a flotilla of cabin cruisers at headed to Guantanamo Bay, where the U.S. government provides terrorists with the best health care in the world. Guards wouldn't let Moore's health-care refugees onto the base, but Moore's motley crew somehow found their way to Havana, where they received red-carpet treatment from the Cuban government.
In the Wisconsin State Journal July 29, John C. Goodman, president of the National Center for Policy Analysis, described by the State Journal as "a conservative think tank," accused Moore of producing a "film that is full of errors and omissions." Goodman neglected to cite a single specific example.
He suggested that under Canada's health-care system, people have no more a right to a particular medical procedure than they do in the insurance-company-run health care system in which the luckiest among us find ourselves. Indeed, a stunning indictment of government-run health care vis-a-vis our system.
"There is not even a right to a place in line," Goodman wrote. "Far from enjoying a 'right to health care,' people in other countries often have long waits for needed care."
In Paul Krugman's July 16 column in The New York Times, "The Waiting Game," he writes about a waiting game played by insurance companies in this country that almost cost UCLA Prof. Mark Kleiman his life.
Kleiman was denied coverage for a biopsy — a subject also discussed in Sicko — because his insurance company wanted him to pay a higher co-pay for the procedure. The insurance company, though, neglected to tell Kleiman that.
In other words, the health-care system that Goodman lauds is susceptible to the potentially lethal waiting games of the systems he ctiticizes.
"The bottom line is that the opponents of universal health care appear to have run out of honest arguments," Krugman wrote in The Times. "All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America."
Moore offers extensive documentation for his portrayal of the dark side of the U.S. health-care system. See
http://www.michaelmoore.com/sicko/checkup/