With little federal movement toward fixing health care, it's time to look to forward-thinking state initiatives like Healthy Wisconsin.
August 1, 2007
Jon Erpenbach and Joel Barkin
Nearly everyone wants something done about our broken health care system -- from the boardrooms of the largest employers, to the busy desks of small business owners, to the dinner tables of working families. The presidential campaigns talk about it, while local governments suffer without it. As Americans turn out in droves to watch Michael Moore's plea for reform in the documentary Sicko, the last decade of government inaction on this issue is getting some scathing reviews.
Insurance companies inflict double-digit premium hikes while reducing the time we get with our doctors. We are less confident care will be there when we most need it, so it comes as little surprise that the majority of personal bankruptcies are due to medical bills. But the federal government has done nothing to ease the crisis.
This leadership vacuum has left state governments to assume the mantle of leadership on health care reform. Massachusetts, Vermont, and Maine have enacted laudable comprehensive reforms that expand access to health care, but they do not go as far as guaranteeing universal coverage.
Wisconsin has taken it one step further. Recently the Democratic-led Wisconsin State Senate declared its independence from the obscene profits of the insurance industry and passed the nation's boldest and most comprehensive health care reform plan: guaranteed coverage for all residents.
"Healthy Wisconsin" would cover all residents not already covered by Medicare, Medicaid, or a federal employee plan. It is built on the premises that everyone should have access to the doctors of their choice, and that residents, government, and businesses should all, to the best of their ability, contribute to make health care work.
The plan, which is modeled after the state employees' and legislators' health plans, provides comprehensive benefits, eliminates premiums for individuals and businesses, and helps people manage chronic health problems. Currently, we spend 80 percent of our health care dollars on 20 percent of the population. Making these people healthier by getting them full access to care would reduce health care costs by tens of billions of dollars.
Healthy Wisconsin gives employers who want to offer care, but are unable because of the outrageous premiums levied against small businesses, the ability to provide coverage. It also levels the playing field so huge businesses relying on government programs to pay for their employees' health care do not gain a competitive advantage on the backs of the taxpayers. In Wisconsin, for example, Wal-Mart's 1,200 uninsured employees cost the state nearly $3 million per year.
Where Healthy Wisconsin truly stands out from other state plans is its funding. It would eliminate premiums, the health insurance tax that cripples businesses and families, in favor of a fair and predictable proportionate payroll deduction, guaranteeing shared responsibility. Employees would pay just 4 percent of their Social Security wages, and employers would contribute 10.5 percent of wages. Sole proprietors would also make payroll-equivalent contributions, and unemployed residents would be covered under existing aid and expanded opportunities the Governor has outlined in the state budget.
The payroll-based finance plan is a fair and simple way to finance health care, as it ties an individual's costs directly to their income and their ability to pay.
With Healthy Wisconsin, the average family would save $750 per year in medical costs, and employers that currently provide health benefits would spend, on average, 15 percent less. In fact, the plan would save state and local governments $1.3 billion per year. Imagine what states could do with the money saved.
The fight for Healthy Wisconsin is well underway. It is, predictably, being attacked by right-wing, industry-funded groups as a "tax hike."
But businesses, local governments, and hard-working Wisconsinites are encouraged to look to the numbers to see how they win under Healthy Wisconsin. The current $18.5 billion being paid by Wisconsin employers and employees would plummet to $15.2 billion. Only a corporate lobbyist would call this $3 billion drop in costs a "tax hike."
The lesson here is that states must take the lead on health care reform. If Healthy Wisconsin makes it through the legislature and gets to the Governor's desk, it would be the boldest and most comprehensive health care reform that we've seen from any state. The action taken by the Wisconsin State Senate raises the bar for health care reform and offers other states and seekers for national office a blueprint for health care for all in America.
There is no question states like Wisconsin have the means to do what is smart. The question is whether we have the courage to do what is right to fix the health care crisis.
State Sen. Jon Erpenbach, in his third term in the Wisconsin State Senate, is chair of the Senate Health and Human Services Committee.
Joel Barkin is executive director of the Progressive States Network.