John Torinus has it wrong in his recent assessment of Healthy Wisconsin, and business readers are left with a misleading analysis that could send them down a more costly path.
Torinus said, "…high payroll taxes paid by employers inevitably put a damper on wage increases." Of course he's right, but very incomplete. He ignores vital, offsetting factors that good business leaders would surely include, an accuracy he would expect from his own managers.
First, the 10.5-percent employer tax (for Healthy Wisconsin) replaces the 15 percent most employers are currently paying for employee insurance premiums, thus wages are more negatively affected today than after the 4.5 percent of wage savings in HW is applied.
Since when does a 10.5-percent cost have impact but a 15-percent cost doesn't? Most business leaders would swap the higher for the lower any day, but obviously not John Torinus.
Secondly, he points to the 4-percent employee tax and doesn't mention that it offsets part of what they are already paying - and additionally, it includes coverage of limited vision, dental for children, mental parity and pharmaceuticals employees are not currently getting paid for. A 16-percentincrease in coverage, and there's no additional cost for a family plan!
Torinus scoffs that David Riemer ignores the "consumerism" in his earlier plan, which included health savings accounts. But there's a rather simple reason: according to the Bell Policy Center, "HSAs coupled with high-deductible health plans increase cost-consciousness among enrollees, but have little effect on overall health care costs."
That's obviously not what Torinus wants to hear, because he uses HSAs in his own company. Health costs will indeed decrease for his company but they will increase for employees. That's the pay cut he argues against! When employees realize that, will they then demand higher wages to compensate for lower benefits?
Healthy Wisconsin makes a systemic change that Torinus apparently doesn't like, nor does the debater he cites - Rep. Leah Vukmir (R-Wauwatosa) - and the other Republicans who share in the $600,000 of campaign contributions they've received from the insurance industry. When an industry gives this kind of money, you just know they are on the losing side of the argument. But money talks.
HW eliminates the 31 percent of wasted middleman costs that are consumed by the current insurance bureaucracy. For the same dollars we are spending today to cover 90 percent of Wisconsinites, we can provide greater coverage to 100 percent instead, so it's hard to understand why Torinus doesn't see the forest through the trees.
These systemic changes eliminate the costs that add nothing to health care, like insurance broker commissions, actuarial costs, costs for cherry-picking and gatekeeping, high executive salaries and the ever-rising shareholder profits. Even the insurer's high costs for lobbying and campaign contributions (to Vukmir and others) that are passed on to the patient are eliminated under Healthy Wisconsin.
It would be a disservice to the business community to not include all of these tradeoffs, and corporate leaders should quit listening to both sides and do their own math. Simply multiply current payroll by 10.5 percent and compare the result with what is now being paid for employee health care and its associated administration costs. Now you have your answer.
Torinus deserves great credit for being ahead of the curve on health care, but in this writers' view, he's not far enough ahead. While he has reduced his costs, he could reduce them more because at least some of his employees are still stuck with the 31-percent burden. Torinus owes it to the business community to get all the facts on the table. Readers may not agree with mine or his facts, but they are experienced business leaders and can sort them out for themselves.
Healthy Wisconsin is not perfect, as David Kliber pointed out in his Milwaukee Biz Blog entry. But we should fix it, not trash it, and the Republicans should take that responsibility. We need a small business transitional tax break, and we should have the health board selected by the new, independent ethics board rather than the governor.
Winston Churchill once said, "Americans will always do the right thing, but only after failing at everything else." Let's prove him wrong.
Jack Lohman is a retired business owner from Colgate and is a founding member of www.BusinessCoalition.net. He is the author of "Politicians - Owned and Operated by Corporate America" and can be reached at jlohman@execpc.com.



3 Comments
Mr.Lohman,
I believe the flaw in your analysis is you are looking only at the current year and not at the future costs associated with "Healthy Wisconsin". I believe the study used by Mr. Riemer and the people who formulated this plan, stated that the payroll tax would need to be increased in future years to almost 20% of payroll. That means your 20% payroll cost compared with 15% currently being spent puts the current system in a more favorable light.
Secondly, you comment on the current systems costs that add nothing to health care. Since when has any government run any program efficiently and at a low cost. One only needs to many of the programs that year after year after year suck more and more tax dollars and still do not meet the goals they have set out to accomplish.
Finally this plan allows people who do not pay into this system participate. How can that not do anything but drive up the cost. Where is their incentive to minimize their use of the system. They will be going to the emergency room for band aids. Heck the band aids will be free and their not paying anything out of their wages. (Because the have no wages!!!!!)
As CFO of a SE Wisconsin Manufacturing company, I think business owners would take a short sighted view of their health costs by supporting this plan. We have managed to keep our premium increases under 15% each year. In fact, most years we have been 5% or less. We did this by educating our employees and incentivizing them to use the doctors office instead of the emergency room.
Consumerism does work in the real world. Our company is evidence of it.
Dean Popek
Thanks for your comment, Dean. Before I start let me qualify my position. I have no dog in this race, and not employed by anybody. I am retired and on Medicare, and it is just great. I see the same doctor and go to the same hospital as before. I get sick and I get care and the caregiver gets paid. The only difference is that they send their bill to WPS for payment, rather than to one of the 450 insurance companies in the state.
You ask what has the government ever done right, and Medicare is one of the most effective and efficient public-private systems ever. Judy Robson has it right at about 8%, though Canada is at 9% and I would have guessed 10% here. The increase in costs is going to increase under the current system OR Healthy Wisconsin, but less so under the latter.
The plan covers the people who are working and not currently paying into the system, yes, and it makes them now pay into the system with a 4% tax on wages. Those not working are already getting free taxpayer-paid health care through ER's and BadgerCare and Medicaid. With HW they will no longer be going to the ER for non-emergency stuff, they can now go to the doctor and we should see major savings there as well. And no cost-shifting. The anti-incentives are the co-pays and deductibles, though that's a subject for another day. I'd like to see them zero for the first few visits and go up progressively if people over-utilize the system.
If by incentivizing your employees you moved to HSAs, you may have decreased your company costs by transferring risk to the employees, and I would project that you will eventually pay a high price for that.
Healthy Wisconsin actually has an excellent system of "consumerism," though not at the "you get sick and you pay" level of HSAs. Here's a piece that you may find useful: http://businesscoalition.net/The%20high%20costs%20of%20medicine.pdf
First of all, calling the insurance companies an industry is a misnomer. An industry is industrious. It's a place that does something. Something tangible is produced. In the old days, industries were characterized by smokestacks and loud machinery.
Today, the look and feel of industries has broadened, but it in no way includes insurance companies. Insurance companies produce nothing except paperwork. They contribute nothing to the gross national product. Much more so than government, they're a drain on society.
A basic tenet of the free market is that companies that aren't successful go bankrupt. They should. Yet the insurance companies, like the grasshopper in the fable, somehow think that the world owes them a living.
Well, we don't owe insurance companies a living. If we can find a way to provide health care to more people for less, we should do that.