Independent Student Newspaper Since 1969

The Badger Herald

Independent Student Newspaper Since 1969

The Badger Herald

Independent Student Newspaper Since 1969

The Badger Herald

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Real, bipartisan leadership needed to tackle health care

There is a difference between running a government and leading one. Gov. Scott Walker and the Legislature have done, for better or worse, a very efficient job of the former, but failed miserably at the latter. They have succeeded in pushing through broad reforms and changing – virtually overnight – the philosophical compass of our government. But leadership requires more than passing controversial legislation. It requires a vision that takes seriously the challenges faced by ordinary Wisconsinites and articulates clear, workable solutions.

Not to say that our politicians don’t have vision. On the contrary, they are filled with it. But theirs is a vision informed more by political orthodoxy than an honest assessment of the problems we face, much less a serious effort to produce solutions that work for Wisconsin. In no area is that more apparent than their approach to health care.

From day one, the new administration threw its lot in with the conservative movement working to subvert the Patient Protection and Affordable Care Act passed last year. The most recent effort in this fight is the ‘Health Care Freedom Amendment’ introduced by Sen. Joe Leibham, R-Sheboygan, and Rep. Robin Voss, R-Burlington, last month. It is a proposed amendment to the state constitution that would “protect citizens from the unconstitutional takeover of health care” by “prohibit[ing] our government from forcing participation in any public or private health care/insurance program.”

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This bill is based on model legislation authored by members of the American Legislative Exchange Council, the policy organization so recently an uncomfortable subject of University of Wisconsin professor Bill Cronon’s research. Using the statehouse to promote a national conservative project like this is less leadership than it is a head-in-the-sand defense of the status quo.

And what an unsustainable status quo it is. The cost of care is economically crippling to families, school districts, local governments and businesses. In 1990, health care spending was 11.9 percent of GDP, up from 7 percent in 1970. By 2009, that figure exploded to 17.6 percent of GDP, or $2.5 trillion. Projections by the Congressional Budget Office foresee an increase to 25 percent of GDP by 2025 and up to 49 percent of GDP by 2082. Health insurance premiums have been rising faster than earnings and even inflation for years. By 2020 families may pay well over $20,000 a year for their insurance.

Rising insurance premiums are a result not only of rising health care costs, but also a side-effect of falling insurance enrollment. Because hospitals and physicians have a moral and legal obligation to provide emergency care regardless of ability to pay, hospitals often take a loss when caring for uninsured patients. They recoup some of that loss by charging extra to patients with insurance. Insurers pass that cost along to customers via higher premiums, which in turn makes it harder for patients to afford insurance.

Leadership from our politicians should begin by recognizing these hard realities rather than hiding behind partisan ideology. It’s fine and well to say, “The government can’t tell me to buy insurance,” but then what do you propose? Should we continue to concentrate the increasing cost of care on those who are – by accident or fortune – lucky enough to have insurance? Should we allow uninsured patients to bleed out and have heart attacks on the stoop of the ER because they can’t pay for their care?

The former option is unfair to families who work hard to pay their insurance premiums and ultimately only contributes to the spiral of increasing cost. The latter, besides being professionally reprehensible, would never stand up in the court of public outrage. Creating a sustainable system requires that everyone who is able pays into the pot, whether in the form of taxes or insurance premiums.

The Democrats have led the way in articulating a vision for insurance reform, however they have largely ignored the more important – and more difficult – issue of decreasing cost. Rather than bicker over insurance requirements, we need leaders – Republicans, Democrats, whatever – with the vision and persuasion to make meaningful and lasting reform.

Seriously tackling the cost issue means taking on a host of powerful groups, from drug and medical device companies to the home health industry to physicians. It will be politically unpopular and extraordinarily difficult but ultimately far more helpful to Wisconsin families. So far the leadership of this administration has been through ideology and sound bytes, but hopefully it can pick up some innovation and creativity along the way.

Geoff Jara-Almonte ([email protected]) is a fourth year medical student going into emergency medicine.

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