As Wisconsin’s health care costs continue to surge among the highest in the nation, political pressure is growing to reform a system that is sick and isn’t getting any better.
The rising costs of employee health care is the top concern of members surveyed by the Metropolitan Milwaukee Association of Commerce, surpassing taxes as the major impediment to business growth in the state.
The crisis is bubbling over on several fronts, but three controversial legislative items related to health care costs are emerging at the top of the agenda:
1. A proposed Wisconsin Health Plan.
2. A call for the creation of a medical insurance malpractice cap that stands constitutional muster.
3.A Cancer Patient Protection bill.
None is more controversial or fundamental than the Wisconsin Health Plan, a bipartisan concept co-sponsored by state Reps. Curt Gielow (R-Mequon) and Jon Richards (D-Milwaukee).
The stakes could not be higher for Gielow, who is risking his political career to initiate a fresh discussion on reforming how Wisconsin residents and employers pay for health care.
His proposal comes at a time when the nation’s political system is more divided and cantankerous than anytime since the Vietnam War and Watergate. Consider:
• The Bush administration is hunkered down in its War on Terror, and anyone who criticizes the wisdom of invading Iraq on false pretenses is accused of being unpatriotic or not supporting the troops.
• Sen. Richard Durbin (D-Ill.) and the like of the far-left are making ridiculous comparisons of the Bush administration to Nazi Germany.
• Red states. Blue states. Conservative talk radio. Air America. Karl
Rove. Howard Dean. Filibuster. Nuclear option.
• A reporter is sitting in jail for refusing to disclose the name of a source for a story she did not even write about a CIA agent whose husband had spoken out against the war in Iraq. The story was actually broken by a conservative columnist, Robert Novak, of the Chicago Sun Times. Novak’s not in jail.
• Any Democrats who support tax cuts or believe public employees should pay greater shares of their health care benefit costs are accused by members of their own party of selling out.
• Any Republican who dares to disagree with the vocal far right wing of the party on a variety of social issues is accused of being a Republican in Name Only, a "RINO," and risks a recall effort or an immediate rebuke with a far more conservative competitor in the next primary.
Indeed, partisan political agendas are superseding the public’s best interests.
With the bipartisan Wisconsin Health Plan, Gielow knows he risks becoming a target of the RINO hunters.
Gielow says he isn’t trying to force anything down anyone’s throats with his plan. A former hospital administrator with a master’s degree in health care administration, Gielow simply believes the time has come to look at Wisconsin’s skyrocketing health care costs through some different lenses. He wants to initiate a discussion that will seek more creative ideas for a vexing problem.
Indeed, Gielow has the most to lose in this game. Wisconsin Republican legislators are chastised for even bringing up Richards’ name in the presence of Assembly Speaker John Gard (R-Peshtigo).
"I’m so far out on a limb here, it’s touching the ground," Gielow acknowledged when SBT invited him to share his thoughts about why he is making such a bold bipartisan proposal.
The local conservative talk show choir immediately chastised him for co-sponsoring the plan.
In Madison, there’s talk of people like Gielow getting "Mary Panzered." The name became a verb when the far rightwing ousted the former state senator because she too had dared to stray from their agenda.
Before employers pass judgment on the Wisconsin Health Plan, here’s some food for thought: If you are an employer and you are providing health care insurance for your employees, you already are paying taxes to provide health care for employees of other companies, such as Wal-Mart, that aren’t providing benefits. Your tax dollars are going into BadgerCare, the state’s program for the working poor.
"The idea was intended to be the starting point in a debate … not the final product or outcome," Gielow said (see accompanying essay). "Those who loudly proclaim it a bad idea should bring forth their own ideas or at least work with this one to make it better. To solve the health care triple threat, we need an effective private market, consumer-focused purchasing pool that harnesses market forces to lower insurance costs…and to ultimately lower healthcare costs."
Joe Leean, a former state senator and director of the Department of Health and Family Services for former Wisconsin Republican Gov. Tommy Thompson, is forming a diverse coalition of interest groups to help develop the Wisconsin Health Plan.
Richards said now is the time to bring large corporations, small businesses, farmers and organized union to the table together to fix a system that is broken, much like Wisconsin did when it invented the unemployment and worker’s compensation insurance programs.
"All of those groups are hungry for change in health care. We need to seize this moment, when we get all of these people together on this problem. We have got a number of small businesses contacting us, saying how much they like the plan and how much they like us working together to solve the problem. I’ve gotten letters from people running small businesses, saying that the current health care system is killing their business and something needs to be done," Richards said.
"We’re certainly open for constructive criticism. There are people who frankly haven’t read it and are mischaracterizing it. People I talk to say the status quo is not just fine. They say the status quo is driving them out of business. Curt and I seldom agree about anything, but this is one time that is different. I think Curt’s getting heat from people who have philosophical problems with what we’re doing. The defenders of the status quo will always find something to complain about in a solution," Richards said.
Thomas Holbrook, University of Wisconsin-Milwaukee professor of political science and former editor of American Politics Research, said the political system has changed in recent years. In the past, the system rewarded moderates who could appeal to swing voters from the other side of the aisle (Ronald Reagan and Bill Clinton, for instance), Holbrook said.
With boundaries of legislative districts being drawn to safely appease incumbent parties, politicians have incentives to serve the "red meat" to their parties’ core constituents, rather than reach across and find compromise with the opposing party, even if the public’s best interests are at stake, Holbrook said.
In previous years, Republicans claimed to have a "big tent" for voters with many viewpoints, but if the most conservative Republicans keep driving moderates out of their tent, they risk ultimately ending up with just themselves in their tent, Holbrook said.
"This is a problem that both sides sort of face. By trying to appeal to their core ideological base, they can alienate some swing voters who can go to the other side. It’s something you are seeing more of these days," Holbrook said. "Twenty years ago, both parities were more tolerant and let their members stray on some issues. The risk you run is being challenged within your own party. You know, a Republican state legislator from Mequon is likely to be safe within a general election, but not in the party primary, when they could throw up someone who’s more conservative to run against him."
Wisconsin used to embrace mavericks such as Gielow and Richards, people who had the courage to stand up for their convictions, people not afraid to buck the system, people willing to do the right thing, people not beholden to special interests.
It remains to be seen if that progressive approach to resolving social problems is a mere footnote in Wisconsin’s history or if it has given way to a system rife with political corruption and narrow minds.
The Wisconsin Health Plan
The Wisconsin Health Plan proposed by state Rep. Curt Gielow (R-Mequon) and Rep. Jon Richards (D-Milwaukee) began as the brainchild of David Riemer and Lisa Ellinger of the Wisconsin Health Project. The following is Wisconsin Health Project’s executive summary of the concept. Additional information is available at www.wisconsinhealthproject.org.
"The Wisconsin Health Plan seeks to address Wisconsin’s triple crisis in health care: the skyrocketing cost of health care, increasing numbers of uninsured, and the ever-present deficit in the state’s Medicaid program.
Wisconsin-specific data show that employers now spend an average of 15 percent of payroll for the health care premiums of their employees. Health care costs are rising 10-25 percent per year, and the result is an adverse economic effect on wages, profits, job creation, and new investment in Wisconsin.
Wisconsin has been a national leader in having low rates of uninsured in our state. Yet, at some point over the course of the year, up to 500,000 Wisconsinites have no insurance coverage. Conservative estimates suggest that 6 percent of our population is not covered on any given day. Lack of insurance is a significant factor in premature death, unnecessary illness, and bankruptcy; and the trends in this area are getting worse, not better.
Wisconsin’s Medicaid program is facing a structural deficit because costs and caseloads are rising much faster than state revenues. The state has relied on short-term fixes to get by thus far, but the ongoing structural deficit in this $4 billion program continues to undermine other state priorities.
The Wisconsin Health Plan provides a new way to pay for health care in Wisconsin. This proposal creates an effective purchasing pool and incorporates "consumer driven" incentives to promote health care quality and use market forces to drive down health care costs.
The proposal has three simple components:
• All Wisconsin employers pay a
fair assessment;
• All Wisconsin residents (under age 65) own a Health Insurance Purchasing Account;
• All participants have an annual choice of health care plans and providers.
The plan is structured in a way that would free up nearly $1 billion in the state’s biennial budget. This revenue could be used to cut taxes or make needed investments."
Steve Jagler is executive editor of Small Business Times. You can reach him at (414) 277-8181, ext. 116, or at steve.jagler@biztimes.com.
