Advocate: State should have health plan ready
6/24/2009
If federal efforts to reform the U.S. health care system fall short, Wisconsin should be ready to implement its own plan for universal coverage, a former state budget director says.
"Wisconsin needs to be prepared to lead," said David Riemer, who was budget director for Democratic Gov. Jim Doyle in 2003 and chief of staff to former Milwaukee Mayor John Norquist. "We can't just sit there staring at our shoes assuming that we're out of the picture." Riemer, director of policy and planning for Community Advocates, which works on behalf of low-income and at-risk people in the Milwaukee area, discussed health care reform with Leader-Telegram editors Monday.
While reforming the nation's health system is a contentious topic, Riemer noted that a broad consensus is forming over what should be done.
"Most Democrats and Republicans agree that everyone should be required to have health insurance," he said. "Most people agree that there should be a pretty good benefit package, (and there is) a lot of agreement on preventive care of wellness."
One of the major points of partisan disagreement, Riemer noted, is the question of creating a government-run "public plan" - such as Medicare or a co-op - that would compete with private health insurers. President Barack Obama supports a public plan, while Republicans have criticized the idea, saying government competition would drive private insurers out of business and raise costs. Riemer said a public plan, rather than being a government-run insurance program, should be an "exchange" that would allow people seeking insurance to choose among competing private plans, much in the same way state employees do when they select insurance. Market forces would lead insurance companies to hold down costs to attract customers, he said. However, to be effective in controlling costs, the plan has to be sufficiently large, so Riemer proposes putting all government employees in it.
The "exchange" idea has supporters on the right as well. It's a key component of the Patients' Choice Act, a bill proposed by several Republicans in Congress, including U.S. Rep. Paul Ryan, R-Janesville. That bill would offer refundable tax credits - $5,700 for a family or $2,300 for an individual - to buy private health insurance. The bill's authors say health plans that participated in the "exchanges" wouldn't be able to reject people based on pre-existing conditions or age, ensuring that the uninsured could get coverage.
"The Patients' Choice Act proves that America can have universal health care coverage without the government running our health care system," Ryan said last month when the plan was introduced.
Ryan's plan would leave much of the decision-making up to states. Such a scenario - and the fact that Congress could fail to enact reform at all - are the reasons Wisconsin should prepare its own universal plan, Riemer said.
For such a system to work, participation must be mandatory, as it is under Massachusetts' universal coverage plan, Riemer said. Those whose incomes fell below a certain level should receive a refundable tax credit to pay for the insurance, he said.
And while the insured should have to pay for some of their care - for example, to reduce unnecessary emergency room visits - Riemer says a universal plan should pay for preventative care, health screenings such as mammograms, and the treatment of chronic conditions such as diabetes and heart disease. Covering preventative care saves money in the long run, he said, noting that under the current system, untreated health problems among the uninsured can lead to huge hospital bills, the cost of which are passed on to those with private insurance.
And while Wisconsin lawmakers should be prepared to implement a program of their own, Riemer acknowledges that's not the ideal scenario.
"I would love Washington to just solve this and have a national plan," he said. "My own personal view is that this is a national problem that requires a national solution."
Resource:
http://www.leadertelegram.com/story-ros.asp?id=BKD9GK6DKK3 |
