Healthy Wisconsin: Separating Fact from Fiction

“Can you really get Healthy Wisconsin passed? We need the plan now.” At summer parades and picnics, in the cafes and through call-in radio shows, the message to me is the same “Can you really get this job done? We need it now.”

Healthy Wisconsin: Your Choice, Your Plan is comprehensive health care reform that provides the same benefits that I have as a state legislator to every man, woman and child not covered by a public program (like Medicare). The plan was recently passed by the state Senate and now awaits action by the state Assembly.

The plan’s passage has created a groundswell of support among average citizens but is not without its detractors. Separating fact from fiction has become a full time job for this rookie state senator.

Here are the facts: The plan covers everyone – unless you are already covered by a public plan like Medicare. People have choices – the type of plan; their own doctor; what hospital to go to and where to work. No longer will people have only the choice their employer offers. Your insurance stays with you no matter if you change jobs or start your own business.

Doctors, hospitals and health care networks are encouraged to provide high-quality medical care. Health care providers stay in the same private sector organizations they are in now. Financial incentives encourage doctors to provide high-quality care – like coordinating chronic disease care. Providers benefit because everyone who walks in their door will have some type of insurance. And patients benefit through encouragement and support to adopt healthy habits – something most of us could use!

The plan is governed by a private board of trustees made up of the people whose money is at stake: businesses (large and small), workers, the self employed, farmers, and consumers. Health care providers serve to as advisors.

The system is a private public partnership; it is outside of state government. As one of the plans key authors, I worked to put in place many systems of checks and balances to add accountability and transparency. It is the people’s money and it must be treated with care. We created a system that was self governing by the people whose money was at stake.

We all know that we pay too much for health insurance and too many people are shut out of the system. To truly solve these problems we knew we needed to get at their root cause. To deal with the problems in our health insurance system, Healthy Wisconsin changes both how money is collected and how risk is handled.

In Healthy Wisconsin, we proposed premiums collected through a payroll deduction and based on wages. Employees pay 4 percent of wages; employers pay 10 and a half percent. Everyone pays, including those employers not now providing health insurance. But the rate is affordable and everyone pays their fair share. Some employers are unhappy about having to pay into a system when they now do not.

But many employers have contacted me with encouragement. People with low wages, low incomes, new businesses just starting up, retirees and those with a spouse who works at home would especially benefit because payment is based on wages (or income if the person makes no wages). For people who are doing well and end up paying more than they do now, many understand that we all need a system that stabilizes costs over time, deals with the ‘hidden tax’ of the uninsured; and changes the incentives from getting sick to staying healthy.

The plan is not without its detractors. Perhaps the greatest misinformation is about how the plan addresses rising health care costs. By changing the way we handle money (through a simple payroll deduction sent to an independent authority) we streamline administration and eliminate waste and paperwork. Independent estimates are that we would save over $1 billion in a single year.

The plan is not a ‘single payer’ system – there are multiple payers including many health maintenance organizations and a fee-for-service system available in all parts of the state.

When we drafted the plan, we set aside ideology and developed a practical solution to the problem. The solution uses competition where it works – the state employees plan provided us that model. But the solution also puts in place rules where they are needed. Everyone is covered – even those with a health problem or a pre-existing condition.

These rules make unhappy people who would profit from denying care to people. But most of us would agree. These changes are long overdue.

You can find details on Healthy Wisconsin at http://www.legis.state.wi.us/senate/sen31/news/ If you have comments, please feel free to contact me: Black River Falls at (715) 284-1730; in Eau Claire at (715) 838-0448 or in Madison at (877) 763-6636 (toll free); or write: State Capitol; P.O. Box 7882 Madison, WI 53707-7882 or email Sen.Vinehout@legis.wisconsin.gov.