Uppity Wisconsin

“Senator Kathleen Vinehout is known for pushing socialized medicine, but no bill was passed because it was ridiculously expensive” claims a letter to the editor in this weekend’s Eau Claire Leader Telegram.

To not change our health insurance system is ridiculously expensive.

We have the highest priced system in the world. Per person costs are twice that of any other country. The share health care takes out of our economy is far greater than any other country. You’d think we would be the healthiest people on the planet.

But we are not.

We rank 19^th of industrialized countries in preventable deaths. We rank 48^th in life expectancy and 29^th in infant mortality.

To do nothing is to continue a system that provides very poor results at a very high cost.

Everyone knows a story of a $350 aspirin, a medical test repeated simply because it was done at a different clinic or a treatment that proved ineffective. Hospital administrators bemoan the rules their billing office must follow when insurers all use different forms, different rules, routinely deny claims and even charge hospitals and doctors for the processing of covered claims.

In a recent Washington Post article, a Seattle health system CEO reported that as much as half of the $2.3 trillion we spend on health care does nothing to improve health. We are not getting value out of the dollars we spend.

But when we propose reform of our system, many people argue it is too expensive. Healthy Wisconsin would have covered 500,000 people who are now uninsured; would have provided better coverage for millions more who are now paying too much for too little and would have still saved all of us over a $1 billion in paperwork alone.

There may be other tradeoffs to debate: the way we pay for health care, the role of insurance companies, the types of choices we have available – but if those tradeoffs bring us closer to the present way of doing things the more expensive it becomes.

Change will be less expensive. And that is confirmed in each jurisdiction where everyone is covered - the costs are far less and the health results are far better.

Healthy Wisconsin, as it was introduced, was funded with a payroll tax because federal law limited the state’s options. People didn’t like how we paid for the plan. But the state may have more alternatives soon. A recent court decision and a new administration in Washington may give Wisconsin lawmakers more flexibility. New ideas are good for debate and flexibility in funding may improve the likelihood of success.

Changing the way we pay for health care is only part of the answer. Across the country there is remarkable agreement on what else must be part of reform.

Government ought not be the provider of health care but rather the organizer of a system based on value. We must begin to pay for results, learn to manage chronic disease, keep care coordinated and eliminate duplication, errors and inefficiency. We must encourage doctors and hospitals to use electronic records and prescriptions. We need to know what treatments work best and reward success and best practices. We must build primary care, prevention and wellness as the foundation of our health care system.

None of this is ‘socialized medicine’. The sooner we can get away from debating false choices – the sooner we can get to a real discussion about what we want our health care system to look like ten years from now.

Anything less will be ridiculously expensive.

State Senator Kathleen Vinehout serves the 31^st Senate District. She can be contacted by mail at Senator Kathleen Vinehout, P.O. Box 7882 Madison, Wisconsin 53707-7882 by phone at 877-763-6636 (toll free) or email at Sen [dot] Vinehoutlegis [dot] wisconsin [dot] gov