Tuesday, April 03, 2007

Health Care Battle Coming Soon to Wisconsin

Typically stories that cover state issues in national publications provide an overview of the topic without any new information.

But this article by Milwaukee-based writer Roger Bybee on health care reform in Wisconsin that appeared on the American Prospect website last week does delve into some new points that I haven't seen mentioned in the state or local media.

The thrust of the article centers on the Wisconsin Health Care Reform Campaign, formed last month as an umbrella group for 31 organizations (and counting) pushing for health care reform in the state. The participating organizations range from labor unions to the AARP to Planned Parenthood to the Wisconsin Council of Churches.

There has been some talk that none of the three health care reform proposals out there today -- the Wisconsin Health Plan, the Wisconsin Health Care Partnership Plan, and the Wisconsin Health Security Plan -- would be the actual proposal that moves forward to the state legislature, and Bybee's article confirms that.

And that's where the Wisconsin Health Care Reform Campaign comes into the picture. Not only has the group served as an umbrella organization for the Wisconsin groups and citizens who want to help push comprehensive health care reform, it also has been the sponsor of a number of public forums on health care reform around the state that are aimed specifically at coming up with a "unity" plan that can be brought to the legislature.

Bybee notes in the American Prospect article that the unity plan could come as early as next month.

With Dems in control of the state Senate and the governor's office -- Bybee cites "insiders" who say Doyle will likely sign whatever comprehensive proposal gets to his desk -- that leaves the GOP-controlled state Assembly as the biggest formal obstacle in passing a reform bill.

But just as looming is the special interest opposition that is sure to greet any proposal. Heading up the anti-reform charge would be insurance and underwriters groups under the umbrella organization I discussed last week called the Coalition for Sensible Health Care Solutions.

While it's my belief that any viable reform measure can't wipe out the insurance industry in Wisconsin, the fact is insurance companies thrive on our current fragmented market that -- with the help of the underwriting industry -- allows for the adverse selection that can transform profits into big profits, and, at the same time, leave thousands uninsured and thousands more under-insured.

The insurance industry will fight hard to maintain this status quo by proposing measures that tinker around the edges while leaving the fundamental problem of fragmentation -- which also just so happens to be its money-maker -- in place, and it will do so under the guise of "putting the consumer in charge" and inaccurately referring to reform plans as "government run health care" or "socialist medicine" despite knowing that consumers as individuals stand little to no chance in the health care market (with the exception of minor and routine procedures; that is, the ones that are largely elective, non-severe, and, as a result, don't cost much). Pooling is the ticket to consumer power while community rating -- the opposite of adverse selection -- is the key to consumer equity, but that's not how it will be framed by those who benefit from the status quo.

The other big guns on the opposition side will be the Wisconsin Hospital Association (WHA), the pharmaceutical lobby, and the corporate special interest group Wisconsin Manufacturers and Commerce (WMC).

The anti-reform impetus of the WHA results from fear that any payer-side consolidation would even out the consolidation on the provider side that currently gives health systems increasing leverage over consumers. The opposition of Big Pharma is similar, stemming from an increase in consumer bargaining power that would come with ending our existing fragmented health system.

As for WMC, although its member groups have made it clear that reducing health care costs is a top priority, the organization's incessant focus on taxes -- which falls way down on the list of member concerns -- suggests any funding mechanism that relies on the shared responsibility of employers in addition to employees won't be looked upon kindly by the biggest spending special interest group in the state.

But as long as the unity plan can demonstrate the savings and cost stability it would provide the majority of employers in the state -- including public entities that pay health care costs out of tax dollars -- the WMC will have a more difficult time explaining how its opposition to the plan is in the best interest of many businesses it claims to represent.

Other right-wing groups like Americans for Prosperity, the Coalition for America's Families, and the Wisconsin Policy Research Institute -- along with talk radio in the Milwaukee metro area -- will also throw their support behind the anti-reform side to create a political frenzy that very likely could be bigger than the fight over the failed TP amendment last year.

All-in-all, it should be an interesting summer and fall in Wisconsin state politics.



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