Published: Wednesday, May 27, 2009
Health care: State mustn't wait for Feds to take action
Health care reform is coming to Washington! At least, a growing and engaged group of citizens is trying to make this a reality. Thousands of people plan to gather at Westlake Center in downtown Seattle on Saturday to press for high quality and affordable health care for all.
The rally is an exclamation point on the long, hard and real work of ensuring that all Americans have health coverage, regardless of employment, gender, age, illness or pre-existing conditions. It comes at the perfect time, when the idealism of the 2008 election campaign is being tainted a bit by the lobbying in Congress. Suddenly, the first words on lawmakers' lips are not "How do we get health coverage for everyone?" Instead, it's "Let's make sure we protect private insurance from a public program that might deliver care more efficiently."
If we are more concerned with maintenance of the current system, we shouldn't be pursuing universal coverage. And if we want universal coverage, the current system won't work.
We tend to assume that the heavy lifting for health reform only takes place in D.C. Wrong. We have already done a lot of heavy lifting in our state. In 1987, the Legislature created the Basic Health Plan. By mid-1992, 22,000 people were enrolled and 29,000 were on a waiting list. Basic Health was and is state-subsidized health coverage for lower income working people whose employers don't offer health coverage. These folks don't qualify for Medicaid, because they make a little too much money, but they don't work for employers that offer coverage. They are the people left out, working hard for lousy wages and no benefits and very little help from the government. Basic Health provided them with sliding scale premiums, with the government subsidizing these costs.
In 1993 the Legislature passed a law that would have led to universal coverage. That law was repealed in 1995. What was left was Basic Health, but without sufficient funding to cover all the people who needed it. The waiting list grew a lot longer. So in 2001, a group of citizens and organizations put together an initiative to increase cigarette taxes to fund increased enrollment in Basic Health to cover 175,000 people. The initiative won by an overwhelming vote -- 2 to 1 -- and carried in every single county in the state.
Sounded good, except for the 2001-2003 recession. The Legislature, eyeing a new pot of money and blind to the need for increased health coverage when employers were cutting back, voted to shrink Basic Health to cover only 100,000. Fast forward to this year. Demand for Basic Health has been increasing again, as people lose their jobs and have nowhere else to turn for coverage. What did the governor and the Legislature do? They wrote a budget that cuts two out of every five participants off of Basic Health. Meanwhile, the Basic Health waiting list has avalanched to almost 15,000 people. Pretty soon these people will be joined by 40,000 others thrown off of Basic Health because of budget cuts.
These are workers whose family income hovers around $38,000 for a family of four. With Basic Health, two adults in a family of four with a total family income of $36,000 pay about $2,160 a year for insurance coverage, plus co-pays, co-insurance, deductibles and other out-of-pocket costs. It is not a free ride. But for thousands of people thrown off Basic Health there is no ride at all. They will just be hoping they don't get sick, and that sometime soon health-care reform will be more than a slogan and the Legislature will come to its senses.
After all, the Legislature didn't have to do this. When lawmakers come back into session next year, they should look at their rainy day fund of more than $800 million, realize that this is a rainy day, and invest $255 million of this in Basic Health for lower income working and unemployed people. With 1 out of 11 workers unemployed, we need expanded health coverage.
Health care is not going to be solved by the federal government all by itself. It needs some pushing and shoving, some policy and some actual progress in the states. Funding Basic Health keeps a promise that the citizens made to themselves in approving the Basic Health initiative earlier this decade. The Legislature should follow!
John Burbank is executive director of the Economic Opportunity Institute (www.eoionline.org ). Write to him in care of the institute at 1900 Northlake Way, Suite 237, Seattle, WA 98103. His e-mail address is john@eoionline.org.
The rally is an exclamation point on the long, hard and real work of ensuring that all Americans have health coverage, regardless of employment, gender, age, illness or pre-existing conditions. It comes at the perfect time, when the idealism of the 2008 election campaign is being tainted a bit by the lobbying in Congress. Suddenly, the first words on lawmakers' lips are not "How do we get health coverage for everyone?" Instead, it's "Let's make sure we protect private insurance from a public program that might deliver care more efficiently."
If we are more concerned with maintenance of the current system, we shouldn't be pursuing universal coverage. And if we want universal coverage, the current system won't work.
We tend to assume that the heavy lifting for health reform only takes place in D.C. Wrong. We have already done a lot of heavy lifting in our state. In 1987, the Legislature created the Basic Health Plan. By mid-1992, 22,000 people were enrolled and 29,000 were on a waiting list. Basic Health was and is state-subsidized health coverage for lower income working people whose employers don't offer health coverage. These folks don't qualify for Medicaid, because they make a little too much money, but they don't work for employers that offer coverage. They are the people left out, working hard for lousy wages and no benefits and very little help from the government. Basic Health provided them with sliding scale premiums, with the government subsidizing these costs.
In 1993 the Legislature passed a law that would have led to universal coverage. That law was repealed in 1995. What was left was Basic Health, but without sufficient funding to cover all the people who needed it. The waiting list grew a lot longer. So in 2001, a group of citizens and organizations put together an initiative to increase cigarette taxes to fund increased enrollment in Basic Health to cover 175,000 people. The initiative won by an overwhelming vote -- 2 to 1 -- and carried in every single county in the state.
Sounded good, except for the 2001-2003 recession. The Legislature, eyeing a new pot of money and blind to the need for increased health coverage when employers were cutting back, voted to shrink Basic Health to cover only 100,000. Fast forward to this year. Demand for Basic Health has been increasing again, as people lose their jobs and have nowhere else to turn for coverage. What did the governor and the Legislature do? They wrote a budget that cuts two out of every five participants off of Basic Health. Meanwhile, the Basic Health waiting list has avalanched to almost 15,000 people. Pretty soon these people will be joined by 40,000 others thrown off of Basic Health because of budget cuts.
These are workers whose family income hovers around $38,000 for a family of four. With Basic Health, two adults in a family of four with a total family income of $36,000 pay about $2,160 a year for insurance coverage, plus co-pays, co-insurance, deductibles and other out-of-pocket costs. It is not a free ride. But for thousands of people thrown off Basic Health there is no ride at all. They will just be hoping they don't get sick, and that sometime soon health-care reform will be more than a slogan and the Legislature will come to its senses.
After all, the Legislature didn't have to do this. When lawmakers come back into session next year, they should look at their rainy day fund of more than $800 million, realize that this is a rainy day, and invest $255 million of this in Basic Health for lower income working and unemployed people. With 1 out of 11 workers unemployed, we need expanded health coverage.
Health care is not going to be solved by the federal government all by itself. It needs some pushing and shoving, some policy and some actual progress in the states. Funding Basic Health keeps a promise that the citizens made to themselves in approving the Basic Health initiative earlier this decade. The Legislature should follow!
John Burbank is executive director of the Economic Opportunity Institute (www.eoionline.org ). Write to him in care of the institute at 1900 Northlake Way, Suite 237, Seattle, WA 98103. His e-mail address is john@eoionline.org.
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