Moving forward on healthcare reform
Now is the time to move forward and reform healthcare.
At the federal level, even George W. Bush in his recent State of the Union address, recognized that our health care system is in need of an overhaul. Senator Barack Obama, a presidential contender, called last week for a single payer system to be in place within six years. Representatives Conyers, Kucinich, McDermott, and Chirstensen are supporting Medicare for All in HR 676.
Here in the Evergreen State, healthcare is an important part of the legislative agenda for the 2007 - as it should be. NPI and Democratic organizations across Washington support the adoption and implementation of a national single payer healthcare system, with universal coverage.
Though our goal is clear, there are many potential paths we could take to reach it. Should we, as a state, move incrementally toward improvements in our current system, gradually extending insurance coverage to wider sections of our population?
Or should we support quicker implementation?
Here's an outline of the different proposals under consideration, as well as a primer on some of the organizations supporting them:
Is it preferable, on the state level, to work in a step by step fashion, while waiting for the federal government to take action, or is it better to insist the states lead the way, in hopes the U.S. Congress will then 'learn by example'?
The Blue Ribbon Commission provides laudable goals for improving overall health. Realistically, the stepwise approaches of the Fair Share Health Care coalition are most likely to be passed by our state congress.
The Washington Health Security Trust plan would offer a more far-reaching approach. Ideally, the basic concepts of this plan, with some modifications, combined with elements of the Oregon Plan to reduce service costs, could assure all Washingtonians that their health care needs could be met, in an affordable way.
Washington could then serve as a model for the rest of the country.
The question is not if, or when, but HOW to achieve meaningful reform. As stated by Guy Saperstein of Democracy Alliance:
At the federal level, even George W. Bush in his recent State of the Union address, recognized that our health care system is in need of an overhaul. Senator Barack Obama, a presidential contender, called last week for a single payer system to be in place within six years. Representatives Conyers, Kucinich, McDermott, and Chirstensen are supporting Medicare for All in HR 676.
Here in the Evergreen State, healthcare is an important part of the legislative agenda for the 2007 - as it should be. NPI and Democratic organizations across Washington support the adoption and implementation of a national single payer healthcare system, with universal coverage.
Though our goal is clear, there are many potential paths we could take to reach it. Should we, as a state, move incrementally toward improvements in our current system, gradually extending insurance coverage to wider sections of our population?
Or should we support quicker implementation?
Here's an outline of the different proposals under consideration, as well as a primer on some of the organizations supporting them:
- Blue Ribbon Commission on Health Care: This much-anticipated report of the governor's 6 month commission was released this month. It proposes no significant systemic changes, but rather offers a set of 16 recommendations, some of which represent general improvements in overall approach, such as a focus on healthy lifestyles and prevention, use of evidence-based medicine, and improvement in data management. While many of its general recommendations are laudable, it relies heavily on a business model, and its answer to problems of access and lack of coverage is to further tinker with insurance policies. For an excellent critique, see Sherry Weinberg's evaluation.
- Fair Share Health Care Coalition - This is a broad-based 60+ group including labor, faith, business, rpovider, and community organization interests. The Washington State Labor Council chairs the coalition, which also includes the State Hospital Association; UFCW; SEIU; the Secure Health Campaign, sponsored by the Washington Community Action Network; and Save Health Care in Washington, sponsored by the Community Health Network of Washington. The coalition supports a series of changes, including providing all children with accessible care; supporting small businesses either through expanding Basic Health or subsidizing their insurance premiums; investing in Basic Health; allowing large employers to participate in a state-administered health care pool; and reforming the insurance industry. Bills to watch which further this agenda include HB 1071, Concerning Access of Health Services for Children, lead sponsor Judy Clibborn (41st); SB 5658, which publicly finances catastrophic insurance for low-income employees in small businesses, sponsored by Karen Keiser (33rd); and HB 1569, which would create a state board to certify and oversee health care plans for individuals and small businesses, sponsored by Eileen Cody (34th).
- Washington Health Security Trust - This bold single payer bill was written by members of Physicians for a National Health Program Western Washington, Health Care for All-Washington, and Health Care That Works. The bill now has sponsors in both the House (Sherry Appleton) and Senate (Rosa Franklin). PNHP is a national physician organization which advocates universal health care nationally; they are now approaching this on a state-by-state basis. This plan would set up a Security Trust to manage an expansive public program. All Washington residents over 18 with incomes over 150% of the federal poverty level and all employers earning $125,000 or more per quarter would contribute to this fund. Tobacco settlement and community health funds would be added. According to its proponents, these sources combined would be sufficient to cover all our residents, including the 600,000 now not insured. The Trust would later negotiate with the federal government to include funding for various federal beneficiaries. While this plan could limit per capita costs to a certain extent by largely eliminating the private insurance bureaucracy for a significant portion of the population, it does not really control the supply side of the care equation.
- The Oregon Health Plan - Former Oregon Governor John Kitzhaber, an emergency room physician, heads We Can Do Better, an organization that is preparing a bill for consideration before the Oregon Legislature this year. Currently, branches of this organization are forming in Seattle, Tacoma, and Olympia. While it is also a single payer initiative, this plan differs from the WHST above in several ways. First, it charges the Oregon Health Fund Board to work with the federal government from the outset to procure state directed funds from Medicare, Medicaid, and the public subsidy portion of employer-sponsored health coverage. It also deals explicitly with issues of cost by defining a set of essential health services and prioritizing coverage of treatments, recognizing that public funds for health care are, after all, finite.
Is it preferable, on the state level, to work in a step by step fashion, while waiting for the federal government to take action, or is it better to insist the states lead the way, in hopes the U.S. Congress will then 'learn by example'?
The Blue Ribbon Commission provides laudable goals for improving overall health. Realistically, the stepwise approaches of the Fair Share Health Care coalition are most likely to be passed by our state congress.
The Washington Health Security Trust plan would offer a more far-reaching approach. Ideally, the basic concepts of this plan, with some modifications, combined with elements of the Oregon Plan to reduce service costs, could assure all Washingtonians that their health care needs could be met, in an affordable way.
Washington could then serve as a model for the rest of the country.
The question is not if, or when, but HOW to achieve meaningful reform. As stated by Guy Saperstein of Democracy Alliance:
"If progressives are going to project progressive solutions and be part of this debate, they will need to do so quickly, because the system is fast collapsing, and decisions are going to be made with us or without us."He's right. Time to organize and mobilize.
