Building Blocks for Change

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Jan 6, 2010 No Comments ›› admin
January 6, 2010

As Congress moves toward a final vote on health care reform, people worry whatever happens in Washington will make things worse in Western Wisconsin. Not much of what folks hear makes them feel Washington might actually help solve problems.

So much focus has been on deal-making and compromise. Little attention is given to what really happens after the bill passes. While not perfect, Congress may provide the building blocks on which the solution to high priced health insurance can be built.

One significant block of health care reform centers on the idea of a health insurance ‘exchange’.  To help understand this concept, think about the Progressive Insurance commercial. You enter the ‘insurance store’ and depending on your circumstances, you can choose from several affordable options. Young, single? Choose a catastrophic plan. Not quite sixty and looking to retire? Here are plans to fit your needs. No one will deny you, not cover your diabetes or charge you more because of asthma.

When you buy insurance through the ‘exchange’, you choose among plans offering different levels of benefits, deductibles and co-pays. The plans are rated on cost and quality and fall into a few easily understandable categories.

You could change the plan in a year if you were unhappy. If you lose your job or decide to start your own business, you can keep your coverage. Individuals and families with lower income, under a certain level, would pay less. But the choice of plans would always follow the people not the job.

Nothing about this is ‘socialized medicine’ or ‘government-run’ health care. It’s the same way I and every other Wisconsin state employee gets health care now.

The health care reform bill also encourages growth of non-profit, member run health insurance cooperatives, like the Eau Claire based Group Health Cooperative.

Why would a company choose to be non-profit? Blue Cross and Blue Shield began in 1965 as non-profit insurance. Most of our hospitals are non-profit. They would like to keep it that way. As would our farm co-ops, credit unions, telephone and electric co-ops.

Non-profit health insurance is common outside the U.S.

Most of the rest of world does not have government-owned and operated health care. It’s more likely doctors and hospitals are private and health insurance is non-profit. Compared to other countries, we pay more for health care and get less because we pay for profits and paperwork.

Changing sixteen percent of the U.S. economy will not happen overnight. Despite the naysayers who see death panels behind every door, we will not see big changes the day after health care reform becomes law. Much in the bill is phased-in over time.

If you work for a large company you may see little change even in the next five years. But if you are a farmer, self employed, own a small business, want to retire early or want to follow your dream and start your own business, you may find affordable health insurance is not the obstacle it once was.

People fear paying higher taxes if they can’t afford health insurance. Both House and Senate bills phase-in, by 2013 and 2014, the requirement everyone must have insurance. But those out to scare people who now can’t afford coverage don’t mention that through the health insurance exchange, subsidies, tax credits and rules on insurance company profits and affordable coverage will be available.

And our BadgerCare health program, stays in place; helping those who are unable to afford private insurance.

The health care reform bills provides common sense changes from which we all benefit like; reducing waste, fraud and abuse of public programs; negotiating drug costs; making it easier for generic drugs to get approved; paying for value not volume; encouraging states to reform medical malpractice; paying for care coordination; making sure people have a regular doctor; educating more nurses and primary care doctors; training and recruiting more rural doctors; investing in our frayed public health system; paying for prevention – something Medicare has never done; better managing chronic disease; encouraging employee wellness programs and closing the ‘doughnut hole’ in Medicare Part D.

To fix health care we must figure out how to cover everyone and bring costs down. Accomplishing this means changing the rules of the game. The new health care reform plan isn’t perfect, but it can provide a foundation on which we in Wisconsin can build a health care system that really does provide everyone with affordable coverage.


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