Offering frequent news and analysis from the majestic Evergreen State and beyond, The Cascadia Advocate is the Northwest Progressive Institute's unconventional perspective on world, national, and local politics.

Monday, June 05, 2006

Introducing Larry Kalb

As Executive Director of the Northwest Progressive Institute, it gives me great pleasure tonight to welcome a new member and contributor to our organization.

I am pleased to announce that a great progressive, Larry Kalb, has joined NPI as our Senior Policy Analyst on Healthcare.

Not only will he be working to build the Healthcare section on our core website and helping to spread the progressive vision of a universal healthcare system, but he'll also be contributing regularly to our Official Blog.

To help introduce Larry to you, our readers, we asked him a few questions about his views on healthcare, and his life experiences. But before we get to the Q&A, here's a short personal background:

Larry currently works in Bellingham for the Whatcom Transportation Authority as a finance department assistant. Prior to this he was an independent German and French to American English technical translator translating corporate and legal contracts, standard operating manuals, websites and patents.

Larry also lived eleven years in Europe, studying one year in Salzburg, Austria and working six years in Paris, France as an instructor teaching English as a second language. Larry was also director of administration for a fine arts school in southern France for four years before coming to the Northwest. Larry holds a Master's degree in German language and literature from Bowling Green State University in Ohio. He speaks fluent French as well.
Additionally, Larry was a national delegate to both the 2000 and 2004 Democratic National Conventions for Bill Bradley and Dennis Kucinich, respectively. Larry is uniquely qualified to talk about the politics of health care reform and about the nuts and bolts of a working system.

All of us at NPI are confident that Larry's rich background, education, and life experiences make him well suited to write and talk about this and other important issues. And now, here's our Q&A with our new Senior Policy Analyst on Healthcare.

Q: You lived in France for a period of time. The French health care system is one of the best. Could you talk about that experience?

Good health is the raison d’être in the grand scheme of the French health care system. Every citizen is guaranteed access to basic quality medical care regardless of pre-existing conditions, age, sex, race, religion, financial status, place of residence, occupation or familial situation. As a documented resident of France I enjoyed the same comprehensive health care benefits entitled to a French national.

The process of obtaining medical care was quite simple. To begin with, I was required to register with the regional Medical Services Bureau to establish a dossier profile particular to me, that is to say, marital status, gender, monthly salary, bank account information and place of residence. Once that was processed, I was issued a medical card and was free to consult the primary health provider of my choice.

Though I could have consulted any number of general practitioners in the neighborhood, my preference was to walk to see the doctor whose practice was right around the corner.

After walking five minutes, I arrived at his office which consisted of a simple waiting area attached to a separate examination room. But what was most striking about his office was that there were no receptionists or assisting nurses or any lengthy paperwork to fill out; he was the only person in the office. My doctor exercised the standard rule of “first come, first served, so I had to wait my turn.

Once my doctor diagnosed my illness, he prescribed medication, swiped my medical card to record my co-payment (that was the equivalent of about $20), and I was on my way to the nearest pharmacy. (I have to point out here that no matter where you go in France for treatment of an illness or an accident, there is only one uniform national prescription claim form and your medical card is valid throughout the entire country).

The pharmacist then filled my prescription, swiped my card to account for the cost of the medication that the French health care system covered and I paid the remaining balance. The transaction was complete.

The advantages of the French health care system are numerous and the most important ones should be emphasized.

First of all, basic medical care is publicly administered and privately delivered, meaning that I was free to choose my own self-employed health care provider. Patients and the public medical services administration compensated that provider. Secondly, my coverage was portable, in other words, I was covered regardless of my employment status or where I lived.

Third, I was guaranteed access despite any pre-existing health conditions or financial ability to pay. In brief, there were no eligibility requirements whatsoever. Lastly, medical benefits were comprehensive. No, elective surgery generally is not covered, but general medical services are always provided.

Q: One advocacy group has targeted Wal-Mart, and successfully (in Maryland) sponsored a bill to impose health care costs on the retail giant, at least partly to illustrate the value of a universal health care system to business. What do you think about that strategy?

While "Fair Share" legislation has been successfully enacted in some states across the United States in recent years to force big employers like Wal-Mart to either provide affordable health insurance for their workers or pay into a state insurance pool, other states still have "free-riding" mega corporations that rely either on federal programs like Medicare to cover employees who are senior citizens or on state health programs to insure children of employees who can not make a dollar stretch far enough to afford family plans.

When neither federal or state health care plans are available, many workers of these large businesses have no other alternative than to rely on charity care by hospitals. But having hospitals shoulder the rising cost of medical care for the uninsured is not a solution either. Still other workers turn to working second jobs that do provide health care benefits or to working spouses whose companies offer family coverage.

Washington State contends that fair share legislation in this state would allow access to coverage for the uninsured thus minimizing health care cost shifting to insured patients. Absent such legislation, the Coalition claims, would increase costs while also menacing the affordability of health insurance already in place for the insured.

"Fair Share" legislation would level the playing field for companies that struggle to compete with Wal-Mart and to help offset the tens of millions of dollars that taxpayers shell out to cover the cost of caring for the uninsured.

The rationale behind such a proposed policy is that it requires companies with more than 5,000 employees to pay at least a 9 percent tax toward health care so as to eliminate "health care dumping" by giant retailers whose main objective is to be more profitable. Some smaller companies already pay as much as 25 to 30 percent of their operating costs on health care coverage for not only their employees, but also on their spouses and children.

Even though I too believe everyone should pay their fair share for quality medical coverage, there are some drawbacks in the proposed "Fair Share" legislation. First of all, such legislation would leave the health care insurance industry firmly in place, allowing them free rein in raising premiums and trimming benefits sans fin. It is common knowledge that a corporation is legally bound to put the interests of the shareholder first; health care insurance corporations are not expected to put their customer’s interests ahead of their shareholders'.

The continual rise in health care costs spells nothing but bad news for small businesses in Washington state: it would keep the size of payroll down, put off hiring of new employees while at the same time leaving some positions unfilled. Some full-time workers will be converted to part-time, some may even be terminated. In their place will come temporary or outsourced workers.

Goods and services will continue to increase in price, rendering them uncompetitive in the market place. Lower profits mean lower take-home pay for the business owner which, in turn, threatens the viability of the business.

Less spending translates into less sales tax being paid which correlates into fewer revenues being collected by city, county and state coffers. The worker…well, the worker gets takes the heat from all sides now, not just the burning sensation at both ends.

Q: Any estimate of the economic impact of true reform?

This question implies a negative impact, but I want to people to start thinking of the positive outcomes.

The greatest economic stimulus ever experienced in American history would come about once true health care reform is enacted for the entire nation. Imagine lowering the cost of health care across the board by 25 to 30% over a span of five years by making an electronic claims and payment system interoperable between doctors, hospitals, clinics, labs, and pharmacies.

With some industries nationwide we can track FedEx packages, bank on-line, trade shares, file taxes or re-new a driver’s license. Wouldn’t it be simpler and better for the patient, and for the doctor, if the patient could choose his or her own doctor, bring their health care ID card with them, swipe it in a card reader at the time of service and have the doctor get paid on the spot with electronic funds transfer?

Doctors would save anywhere between 30 to 45% in overhead costs by eliminating the need for outside billing and collection services, not to mention all the clerical staff employed to fill out insurance forms.

What could you do with the money you would be saving if true reform were enacted? Encourage entrepreneurship of small cottage businesses would be created providing jobs for artisans who otherwise would have had to depend on their spouse for insurance coverage. Small family farms would again be able to flourish with the extra money available to put back into buying land, purchasing and maintaining equipment and hiring extra help to till the land.

Artists would be able to study the fine and performing arts to their hearts' content. Galleries would pop up all over the Midwest reclaiming the virtuous culture of painting, drawing, folklore and storytelling.

Business owners would again become more competitive in the market place once they have funds to take on the desired engineer or specialist to create the most innovative product.

Families would be able to save for their kids’ college education or put down money for a new house or car, buy new clothes, or simply go on vacation since there would be no need to work that second job that provided health care benefits. Non-profit organizations would be able to hire more people and contribute more to the betterment of society.

We would preserve our investment in higher education by separating health care coverage from employment, more economic opportunities are created. When our college graduates are unable to find worthwhile employment in Washington, our investment in their training is wasted and Washington loses more of its intellectual capital. Additionally, new graduates will not suffer a gap in health coverage while they search for that first job.

True health care reform would encourage humanitarian treatment for migrant workers through the inclusion of critical but under appreciated migrant workers and their families in the health care system. In doing so, we assure the responsible support of those who otherwise would be at the mercy of illness and ultimately burden the emergency facilities of our hospitals.

True health care reform would encourage early retirement to open opportunities for younger people by making it possible for a worker to retire. Universal coverage system will make it possible to do so, thus opening an employment position for a younger person.

True health care reform would encourage the unemployed to accept entry-level positions - the entry-level position will still provide health care benefits equal to that of an executive-level position.

True health care reform would permit lawmakers to move on to other critical matters by finally resolving the health care crisis - since every year the legislature devotes substantial time to debating, again, the issues surrounding access to health care, Medicaid allowances, coverage for Washington employees, and medical malpractice reform, all of which detracts from other critical issues of the day. A bold move to resolve the health care dilemma through a balanced and fiscally responsible solution opens the legislative agenda for other matters.

I hope you'll join me in welcoming Larry to our organization. Look for him to be posting regularly here on the Official Blog beginning this week.

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