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7/23/2007
Lower costs BEFORE we offer universal coverage

Healthy Wisconsin. Universal coverage. Yes, it’s the goal. But stupid – and expensive – to do it now. Before creating a massive state program, we absolutely must first control health care costs.

Once again, John Torinus, CEO of Serigraph Inc., snaps our heads around on the issue. And he snaps our heads around not by whining about ‘caring about each other’ or about ‘the most vulnerable among us.’ But rather he goes to a private industry example, citing KI in Green Bay as

“arguably the place to benchmark in the private sector for best practices on simultaneously delivering health care and controlling health costs. Its self-insured plan offers a full set of benefits, stresses wellness, prevention and fitness and brings it in for less than $6,000 per employee.”

Wow. Less than $6,000 per employee.

That’s half of the state’s costs – an average of $11,880 in premiums alone, per employee. It’s one-third of what some school districts report as a family premium.

And the benefit plan is “well regarded” by KI employees. How do they do it? By empowering the consumer. Imagine that.

“Its incentives prompt judicious behavior by its workers in how they use and purchase medical treatments, in their lifestyles and in following disease regimens.”

As Torinus points out, that comparison of the KI program to the state cost is important – because Healthy Wisconsin IS the state employees program.

Torinus again:

“If universal coverage is the goal, and it should be, there are less onerous, bipartisan ways to get there…. [for example] applying consumer-empowerment disciplines [e.g., KI and Serigraph plans] to the [state employee] plan and the state’s nearly $2 billion bill for Medicaid, and then using the enormous savings for… insurance subsidies. Figure that a one-third reduction is possible in the $3 billion spent in those two areas.

“Properly structured, like KI’s plan, there is more than enough money to cover everyone in the state – without a massive payroll tax.”

Absolutely. It can be done. It is being done. Legislators and voters must absolutely insist on lower health care costs before we offer universal coverage. Universal coverage that is critical for America. Legislators, agency staffers, please get to work on the basics. HSA’s. Individual empowerment. Preventive health care. Controlling “life-style” diseases. Lowering costs.

Get to work. Now. Fast. And that doesn’t mean Healthy Wisconsin.

COMMENTS

I agree Jo. I really think that we need a "blue ribbon" commission to look at all State spending. Health care and Education included.

We need to set a financial goal, and then we need to MEET it.
How do we set the financial goal? Tough decisions. Folks who feel the state needs to take care of us all would set the goal differently than folks who believe otherwise. Perhaps we need a leader with courage and wisdom. Any ideas? JE

David (Mon Jul 23 12:59:34 2007)

There is only one single payer plan under discussion for Wisconsin, one which takes the insurance companies out of the game and that is the Wisconsin Health Security Plan.

The film Sicko is currently playing in town at the Marcus and Regal theaters and I encourage people to attend. As Moore said before the statehouse in California, "It's time for them (insurance companies) to go."
Lon, here's the deal. Consumers MUST be responsible for their own health care. If they want to work without a middle man, i.e., the insurance companies, let them make that decision. You and SiCKO can whine all you want, but consumer empowerment must come first. JE

Lon Ponschock (Mon Jul 23 15:02:18 2007)

Thanks for highlighting this piece. The KI issue is worth considering. And yes, we each need to be responsible for our care as we are for other parts of our lives. (And this from a teacher!). I fear if we don't get working on something innovative, the masses will wearily agree to something single-payerish out of desperation. As an aside, in working at CENTCOM here in Tampa for a temporary USAF deployment, I learned that some coalition officers (UK) are getting several health procedures completed here before returning to the umbrella of the National Health Service, which recently assumed responsibility for the UK armed forces. It's one example, but they're voting with their feet as their circumstances allow.
Interesting Brady. Thanks. Take care of yourself down there. JE

Brady Kiel (Mon Jul 23 21:54:41 2007)

I'll take one more shot at this and then stop 'whining.'

[It's interesting that in the last election Republicans attributed their victory to 'moral values' but here 'taking care of each other' is considered whining.]

Well, I didn't say take care of each other or anything like it.

The single payer model does not portend to lower cost for in-kind treatment What the single payer model does do is take profit out of the equation for health care.

As to lowering costs, an object lesson for Wisconsinites was in a documentary from a British broadcast called "Drinking Ourselves To Death." The film showed the problem of binge drinking in UK and then showed how a bus was sent around to party spots giving free tests for the liver.

I wonder what results such an action would do on College Avenue on a Saturday night?

The UK saw this as a problem for the National Health (figuratively and literally) and took steps to reduce it's expenses due to lifestyle diseases through testing and education. It is done within the system and does not rely on the 'magical thinking' of consumers.
In other words Lon, the thinking is done by the government instead of by the individual. When you start calling thinking for ourselves, 'magical thinking,' we are in trouble. JE

Lon Ponschock (Tue Jul 24 12:29:50 2007)

Torinus says nothing about the level of deductibles for employees. Isn't the true cost of my health care the sum of the employer's portion plus what I pay directly? See In Effect's analysis of Torinus's message. Of course a CEO will think it's "well-regarded" by employees. You think Torinus has the same health care outlay as his employees? You think by merely "insisting" on lower health care costs, it'll happen? Says who?
Torinus doesn't "insist" on lower health care costs, he and his Human Resources staff work hard at it. Your point about the total cost to an individual and family is a good one. Torinus calls it "all-in costs" - I'll see what I can find out. JE

Mr. Torinus describes his "all-in" average cost per employee of $7,400: "It includes every drop of health cost, employee and employer, dental, mental, drugs, HRA, prevention, wellness, disease management, on-site nurses, administration - everything." JE

John Foust (Tue Jul 24 12:46:00 2007)

"Consumers MUST be responsible for their own health care."

Like consumers who do irresponsible things such as contract cancer, Lou Gehrig's Disease, multiple sclerosis, or bear a child that has Down Syndrome or muscular dystrophy (should the woman have gotten abortion?), or have the audacity to live into their 90s and need nursing home care.

All hail the free market!!!
No, no, no. I resent your implication. When disease or tragedy strikes, the goal is for all to have available the best care possible. I'm not sure that includes experimental, very expensive, low efficacy treatments. And I'm not sure about how best to limit care for 90 year-olds (i.e., you're not going to give a 90 year-old a lung transplant, that kind of thing). But I am sure that we've got to control costs where we can (like many employers are, with prevention - and management of chronic diseases) so that indeed the system can ultimately afford to treat all of us when disease strikes. JE

Northern Pike (Tue Jul 24 19:06:19 2007)