Washblog || Structural healthcare reform is on the table in Washington

Structural healthcare reform is on the table in Washington

By noemie maxwell
Tue Jan 22, 2008 at 07:39:49 AM PST
Section: Washington State Topic: Health

Senator Keiser opened yesterday's Health & Long-Term Care committee session with the observation that it was a "big day". This was the start of hearings considering, for the first time in many years, major structural reform of the state's health care system. Four Senate bills were under discussion, representing what I understood as 4 of the 5 major proposals now being considered. My husband and I signed in as supporting the most comprehensive of the four, Senator Keiser's and Kohl-Welles' Washington Health Partnership bill. See below the fold for more information on these five proposals.

UPCOMING

WA Senate Healthcare Reform Web Dialogue, 1/22 and 1/23: http://www.webdialogue.net/wasen/healthcare. This page links to comprehensive info on health care reform in WA.
Annual public meeting, Physicians for a National Health Program, Western WA: Effects of Uninsurance on our Communities (Sunday, February 10, 7pm, Kane Hall, University of Washington, free admission.) PNHP advocates for a single-payer national healthcare system and moving toward a national universal health care coverage with a state-by-state approach.

The four bills that received hearings yesterday:

SB 6221: Establishing the Washington Health Partnership, Sponsors: Senators Keiser and Kohl-Welles
SB 6603: Establishing the Guaranteed Health Benefit Program Act, by request of Washington State Insurance Commissioner; Sponsor: Senators Fairley, Kohl-Welles, and Fraser
SB 6030: Providing Health Insurance Options for Young Adults, Sponsors: Senators Parlette, Schoesler
SB 6574 Reforming the Healthcare System in Washington State, Sponsor: Senator Pflug

Among those testifying were Washington's Insurance Commissioner Mike Kriedler, who requested SB 6603, and Wisconsin Senator Jon Erpenbach, a sponsor of Wisconsin's Health Security Act, which SB 6221 is modeled on. An additional major proposal was not up for a hearing yesterday. "Creating The Health Security Trust": SB 5756 and HB 1886, would "create a framework and process to involve the citizens of Washington in the creation of a single financing entity called the Washington health security trust". Similar to Senator Keiser's proposal, this approach would generate savings by eliminating "excessive administrative costs resulting from the current fragmented system of multiple insurers". The cost savings would ensure comprehensive health care coverage for all Washington residents independent from employment.

The more comprehensive approaches represented by both SB 1661 and by SB 5756/HB 1886 are backed by two Washington organizations that were represented at the hearing, Washington Health Security Coalition, a coalition of over 20 organizations and Physicians for a National Health Program.

I thought I understood that SB 5756/HB 1886, which is the most comprehensive proposal of all, was preferred by these two organizations and will require some citizen support to receive full consideration along with the other proposals.

Section 1 SB 6221 provides a good overview of why structural reform is not only critically necessary - but unavoidable:

From the introduction to SB 6221 Establishing the Washington Health Partnership

The legislature finds that:

Nationally and locally health care costs are inflating faster than the consumer price index and wages;
Since 1980, health care costs have increased from nine percent to sixteen percent of the nation's gross domestic product, and are expected to exceed twenty percent by 2016;
Other industrialized nations provide universal health care coverage, but spend much less. Some spend less than half as much per person;
In 2007, the average annual premium for family coverage was more than twelve thousand dollars, of which over three thousand dollars are paid by the worker;
In 2008, of Washingtonians under the age of sixty-five, over one million three hundred thousand will spend more than ten percent of their pretax family income on health care costs. Eighty-four of these people have insurance;
Every thirty seconds, someone in this country files for bankruptcy in the aftermath of a serious health problem. Of those who file for bankruptcy, sixty-eight percent had health insurance;
In Washington state, approximately thirty cents of every dollar received by hospitals and doctors' offices is consumed by the administrative expenses of the health plans and the providers. Before the doctors and hospitals receive the funds for delivering the care, approximately fourteen percent of the insurance premium has already been consumed by health plan administration;
In 2006, hospitals, physicians, community clinics, and other providers spent a combined total of five hundred eighty-four million dollars in uncompensated care for the uninsured, a twenty-eight percent increase since 2002;
The institute of medicine estimates that between thirty and forty cents associated with every health care dollar is spent on costs of poor quality - overuse, underuse, misuse, duplication, system failures, unnecessary repetition, poor communication, and adverse events attributable to medical errors;
Rising costs have led to a decline in employer-provided health benefits. In Washington, since 1993, employer-based coverage declined from seventy-one percent to sixty-five percent;
In 2007, fewer than half of small employers in Washington are able to offer coverage to their employees;
Rising costs are seriously threatening the physical and fiscal well-being of Washingtonians, the ability of Washington businesses to compete globally, farms to thrive, government to provide needed services, schools to educate, and local citizens to form new and successful business ventures.

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Structural healthcare reform is on the table in Washington | 3 comments (3 topical)

What you need to say to Sen. Keiser

As recommended by Physicians for National Health c=Care--Western Washington.

Dear Senator/Representative ____

I ask that you support Senator Karen Keiser's (SB 6221) and Representative Eileen Cody's (HR 2536) "Working Group" legislation for the economic analysis study and subsequent public forums comparing models of health care reform for our state. In order for this study to be meaningful, however, a public insurance model, such as the Washington Health Security Trust (SB 5756, HB 1886), must be included along with the four models already proposed.

I would like to address three points:

First, a public insurance model is an excellent one that has the greatest potential to cover everyone in the state, while controlling costs, thereby getting us to a sustainable, high performing health care system. A public insurance model has already been included in at least 14 studies in other states. It is the only model found to cover everyone without increasing costs. When compared with other models, it is the only one to fulfill the Institute of Medicine's criteria for universal health care. At least nine of these studies were done by the Lewin Group, now under consideration for conducting the Working Group's economic analysis.

Second, a public model is sufficiently different from the others to warrant study. The other models being considered in this bill are either not comprehensive or are public/private models. Only a public insurance model does not fragment the risk pool or offer inequitable, tiered coverage. The other models continue to be structured around private insurance markets, with a supporting role being played by public insurance programs, whereas the public model is the only one that reliably restricts the private insurance industry. Administratively, it is simplest and least costly. A public insurance model is clearly different.

Third, a public insurance model should not be disregarded as being "not appealing to the public or not politically feasible at this time." I believe you will find the public model to be the most favored pathway to reform when the study findings are discussed in the Working Group public forums.

* The public will support a public insurance model. A recent Associated Press poll found that 65% agreed that the US should adopt a universal health insurance program in which everyone is covered under a program that is run by the government and financed by taxpayers. 54% of responders considered themselves supporters of a single-payer health care system in which everyone would get their insurance from a single government plan.

* Health care professionals will support a public insurance model. The recent Commonwealth Fund Commission on a High Performance Health System and American College of Physicians position papers endorsed a public insurance model as one of two pathways to an equitable high-performing health care system.

* Other legislators support a public insurance model. Both houses of the California legislature passed a public insurance bill last year (vetoed by the governor). What's feasible in California should be feasible in Washington, given Democratic control of both houses and the governorship.

In summary, I believe that unless a public insurance model is included in the Working Group legislation, that I, and all Washingtonians, will be unfairly denied the opportunity to examine, compare and express meaningful choice as we make major decisions on how to fix our broken health care system.

Sincerely

by eridani on Wed Jan 23, 2008 at 01:40:29 PM PST

* 1 none 0 *

In my Doctor's office today. Asked him about it.

He had no idea of what I was talking about. Last time we talked Universal health care it had to do with SICKO and his own reasons for rejecting universal health care.

Arthur
You sure you ain't staking too much on yer theories? Not enough common sense?

by Arthur Ruger on Wed Jan 23, 2008 at 06:41:11 PM PST

* 2 none 0 *

Update: Good News

The WA Health Security Trust bills have been added to the reform proposals that will be included in a comparative analysis of all the plans under consideration.

What this means:

HB 2536 and SB 6333, "Establishing a Citizen's Work Group on Health Care", would authorize funding to study the economics and effectiveness of structural reform plans now under consideration by the legislature.

Until yesterday, however, this legislation left out the most comprehensive proposal, represented by SB SB 5756/ HB 1886 (Health Security Trust -- see links in story). Two citizen groups cited in the story above, Washington Health Security Coalition and Physicians for a National Health Plan, had been advocating for the inclusion of this more comprehensive proposal. That has now happened.

What this means is that, as Eridani's comment above notes, a public insurance model will be included in the plans under consideration. This is an important step forward.

by noemie maxwell on Thu Jan 24, 2008 at 09:18:40 AM PST

* 3 none 0 *

Structural healthcare reform is on the table in Washington | 3 comments (3 topical)

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