Monday, October 23, 2006

Doyle & Green on Health Care Reform: The Difference IS Huge

When Mark Green finally released his health care plan earlier this month, I wrote:
But, then again, actually addressing the growing health care crisis in Wisconsin wasn't really a goal of Green's health care proposal, anyway. The goal was simply to get some talking points out on paper to use to muddy the waters at the gubernatorial debate in two weeks, part of which will focus on health care reform.

All Green needs to do now is throw out the traditional GOP talking points on health care -- including stand-alone HSAs, medical malpractice caps (which already exist in Wisconsin, but Green wants to make them stricter despite a state Supreme Court decision that deemed such caps unconstitutional), and now HOAs -- to make it seem like he's focused on the problem.

Most voters won't look into what the proposals actually mean for Wisconsin, they'll just be satisfied that both candidates have considered the issue and have a plan to address it. Any difference is just a difference of opinion, not necessarily right or wrong.
Case in point, today's Journal Sentinel article titled "Differences on Health Care Not Huge." In reality, of course, there is a big difference between the health care proposals by Doyle and Green.

Everything that Green has proposed deals with removing health care from the reach of the public sector with the sole exception of the state forcing providers to make prices more transparent (a movement that's already taking place across the country, including right here in Wisconsin, although the research on its effectiveness is less than glowing).

Green's focus on "the market" amounts to state tax breaks for HSAs, encouraging people to pay for their own long-term care insurance rather than participate in state programs like Family Care (which Doyle fought to expand during his tenure), and reducing awards for victims of medical malpractice.

Green, of course, doesn't need to provide any evidence that these proposals will work, he just needs to list them. The media will then help sell them as "market-based strategies," like
the JS did in this article, as if that inherently means something useful for the growing crisis.

Meanwhile, Doyle's signature proposal is BadgerCare Plus, which would consolidate the three major state health care plans -- Medicaid, BadgerCare, and Healthy Start -- into one program to help streamline and reduce administrative costs. This savings would subsequently allow broader participation in the program -- the ultimate goal being coverage of all children in the state, 91,000 of whom have gone without health care coverage in recent years.

And Doyle did take the time to provide evidence that BadgerCare Plus will work. After announcing the plan in January, Doyle set-up a series of forums to develop the plan throughout the spring. This resulted last month in a detailed 36-page plan, complete with a fiscal estimate and a strategy for implementation.

So what Doyle is proposing is an expansion of state health care programs that directly results in more coverage for the uninsured, while Green is proposing incentives to reduce participation in state programs without providing any evidence that this will expand coverage or reduce costs in the state.
What's more, Doyle has been pushing health care reform in this race since the spring, while Green didn't even release a plan until this month.

How much bigger of a difference can you get between the two?

Of course, since the BadgerCare Plus has been getting rave reviews (even GOP state legislator Carol
Roessler praised it), Green has changed his tune on it a bit.

When Doyle was touring the state over the summer to push the plan, all Green could muster for a comment was that he favored "private sector solutions" to the growing health care crisis in Wisconsin. And when the JS asked Green about the BadgerCare Plus plan directly last month, here was the congressman's response: "[R]ather than expanding government-run health care as Jim Doyle has proposed, I believe we should look for ways to make health care more affordable in the private sector."

That's a "No," right?

Well, according to the JS article this morning, now it seems Green is claiming "the program is one that he will consider."

I suppose if there's one thing a lack of real conviction or interest in health care reform affords Green, it's the ability to change his mind on it at the drop of hat.

And, if elected governor, I wonder what Green's mind would tell him about including BadgerCare Plus in his first budget proposal once the election attention is off in January.


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