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9/27/2007
Erpenbach vs. Vukmir - stark differences
Fascinating experience. Tuesday night it was the chair of the Senate Committee on Health and Human Services, Senator Jon Erpenbach, explaining, Healthy Wisconsin – his baby. Then last night, I listened to Leah Vukmir, chair of the Assembly Committee on Health and Healthcare Reform, explain the vagaries of Erpenbach’s program. Fascinating.
The attendees couldn’t have been more different. What a country we live in – that folks so different brush shoulders with each other, walk the same grocery aisles – and in the end, have to figure out a way to work together on this stuff.
I know I’m on dangerous ground here, lumping folks together. But it was so stark. The majority of folks listening to Senator Erpenbach came to hear what Healthy Wisconsin was going to do for them, how they could get better health care coverage – or just any health care coverage. Anecdotes included tragic stories of unavailable medical care, as well as the woman’s cat that was treated better than she was in their respective hospitals (you had to be there).
And then there was the Vukmir crowd, which also included Representatives Phil Montgomery, Karl Van Roy, and John Nygren. A larger turnout by far, these were small business people very concerned about the costs of Healthy Wisconsin. Dare I say that these were folks not interested in the government helping them?
Common Ground
Though radically divergent objectives (government help me vs. government stay off my back; free markets vs. government must make things “fair”), common ground exists between the two bodies of thought. Most policy-makers, on the left or the right, believe: - By hook or by crook, virtually all residents must be insured. (Universal insurance, not universal health care.)
- Portability is critical.
- Quality and cost transparency is critical.
- Tort reform is critical.
- Sharable medical records technology is critical
But the critical difference is personal responsibility
Erpenbach said “Everyone will pay their fair share.” You know what that means. My fair share is a whole lot larger than the fair share of those who only work a few hours a week.
Vukmir said “You can’t take the responsibility for their care away from individuals.” Just what I’ve been saying all along.
HW just doesn’t work
For all the talk of actuarial studies (the details of which HW advocates won’t reveal) that confirm this or that, here’s what says this is just too much in the smoke and mirrors department. Let’s say Wisconsin’s average household income is about $50,000. With Healthy Wisconsin, that household (employer and employee) will pay $7,250 in health care premiums. But right now, some employer is paying $12,000 to $20,000 to cover that same family. Erpenbach says the difference is the value of pooling – and of course, of eliminating those money-grubbing insurance agents. I know – I’ve vastly oversimplified it. But actuarial tables or not, I just don’t buy it. And that’s only the working stiffs. Who’s covering those in the state who aren’t working?
The numbers just don’t add up – and Wisconsinites are right to be worried about it.
COMMENTS
Jo, employers are already paying for the un and under-insured through cost shifting. When employers contribute to the health care of their employees there is in effect a surcharge added by the providers to cover the cost of the non-reimbursed care. I think transparency would be in order for the insurance companies and the providers. We do not see the overcharges as employers and therefore are not aware that we are already paying more than our fair share. Additionally when I think of consumer responsibility I do not think only in terms of fair share participation in cost, I also think about personal responsibility for taking care of oneself. Drink more water, eat more skinless chicken breasts, quit tobacco use, slow down drinking. wear seatbelts and helmets, control obesity, control diabetes, control hypertension, get more exercise. This is a very complex question and will not be resolved with simple solutions. The solutions lie in fair share participation and individual responsibility to care for ones health.
Bob Pedersen (Thu Sep 27 08:04:46 2007)
Please Jo, tell us the Republican ideas then.... and saying HSA a thousand times isn't a solution. HW may not be perfect but it is an idea, which is more than I've seen come from the Republicans
Don (Thu Sep 27 08:07:30 2007)
The one main part that the left is not telling us, is that the projected costs they have shown are only for those working people. The cost of now getting the unemployed and lest we say Illegals, has yet to be factored in. So what may sound good to you now will at least double. I fail to see the bargain here. One of the things that all the uninsured number crunchers are not telling you is that, the number of uninsured is bigtime skewed. The 18 to 34 crowd who thinks they are heathy and at this time have no need for monthly premium payment do this by choice. Why should they be made to have something they don't at this time in life want?
Remove the illegals from the equation and again the number of those uninsured again goes way down.
If we start down the path of government deciding what is my choice to do, we have opened a huge pandora's box. How about if "I" the government, decide everything for you and have you give me your paycheck and "I" will decide what you need and don't?
Jim (Thu Sep 27 12:04:27 2007)
Erpenbach paid a visit to the Appleton Library Tuesday evening. I just happened to see Steve Wieckert and Penny Schaber there at the same time so I figured something was up. Sure enough downstairs there was a meeting on HW.
One of the audience at the APL mentioned that elective procedures like knee surgery would come out of the general pool or words to that effect and why was that and so on.
Knee surgery elective? This came from the everybody should have the freedom to make their own choices side of the aisle.
I suppose you can also "choose" to hobble around.
But the next thing that occurred to me was toothaches are not elective either. Nor is the need to see where you're going with glasses. Optics and dental are not covered by the plan. So the plan is still incomplete.
I got the opportunity to ask the first question at that session which was why was Wisconsin Health Security not given more consideration. Senator Erpenbach's reply fell along the lines that a single payer plan was not ready for prime time.
The group as a whole did not think much of continued participation by insurance companies.
When pressured to give a response on whether he'd vote for the plan, Wieckert did not give a commitment to support it.
Lon, elective surgery typically means that the time and place are elective, can be chosen beforehand. You can, as they say, shop around. JE
Lon Ponschock (Thu Sep 27 12:37:08 2007)
I accept the correction. I have had no insurance of any kind in my life until recently on Medicare. For this reason and having had no surgical procedures I'm not too much hep to the jive of what's elective and what's not.
In this context elective is about choice. For the uninsured choice is not an option and so here again no coverage means no options. Please don't speak for those who cannot make such decisions at all.
Lon Ponschock (Thu Sep 27 23:41:24 2007)
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