The 2014 legislative session showed anew the power of money in health care.
Big-box stores sought to further displace audiologists’ small businesses by seeking greater authority for “hearing instrument fitters” who lack the extensive clinical, and diagnostic, training of audiologists with graduate degrees.
Grandiloquently renaming fitters “hearing aid specialists,” a House bill allowed work with no degrees and “work-based learning permits.” In an aging society where hearing loss is a growing problem, and given the importance of hearing to whole-body health and the great expense of hearing aids (often uncovered by insurance), consumers are hardly protected by allowing stores known for bargain-rate toilet paper to provide medical training.
Other big companies seeking to benefit included some selling “hearing aids” that are simply sound amplifiers, no more diagnostic than the ear trumpets featured, often to comical effect, in movies about bygone ages. And the mere 520 hours of “work-based” training allowing one to avoid direct supervision of this medical care would be less than the 600 hours state law requires of a manicurist, or the 1,000 hours for barbers.
One of the big-box beneficiaries gave $45,626 in state political contributions in 2012. A Senate amendment marginally improved the bill by requiring study of the “work-based learning” element.
This was not the only blow to health care consumers. Due to conservative histrionics about “single-payer health care,” the Affordable Care Act follows a commercial insurance model. Yet the ACA, in many states including Washington, has blessed with taxpayer dollars what, effectively, were already single-payer systems in the individual market.
According to recent data, 63.2 percent of health insurance bought through Washington’s Healthplanfinder — or “exchange” — came through Premera or Premera’s wholly owned subsidiary Lifewise. Put that in perspective: the next closest carrier was Group Health at just 17.7 percent. There are counties where Premera is your only option.
This effective monopoly will only be cemented, and expanded, by four-fifths of exchange enrollment being subsidized through federal tax dollars.
Yet Premera killed a bill to allow scrutiny of what it actually spends money on. The bill would have given consumers, including businesses, access to a basic statewide-price database — allowing them to compare prices for hospitals and other providers. So logical was this idea that those suing to overturn the ACA were among those lobbying in favor. And Premera’s fingerprints were not obscured on the knife: After a Senate committee chair did its bidding, Premera publicly thanked her.
Deservedly, this created bad publicity and editorial hand-wringing across the state.
However, it was nothing new. Killing examination of what it spends money on is only Premera’s most recent success; for years now, it has even killed examination of how much money it has. Premera opposes legislation to give the insurance commissioner authority to regulate the over $1 billion in surplus it has accumulated on the backs of consumers, contracting providers, and its own brokers.
Unlike regulators in other states that include neighboring Oregon, and even Arkansas, Washington’s commissioner — in examining premium increases — must, under the law, simply pretend the enormous cash cushions of “nonprofit” insurance carriers don’t exist.
Premera’s success may have something to do with the $290,400 it showered upon politicians of both parties in the last election cycle. Presumably, this amount will increase due to forced ACA enrollment. Thus all Washington citizens — whether they are Premera policyholders or simply taxpayers — will contribute toward Premera’s political investment strategy. What a national report by the union UNITE HERE labels “one of the largest transfers of public wealth to private hands ever” is certainly the biggest such transfer since the transcontinental railroads were beneficiaries in the Gilded Age.
Welcome to your new health care system!
Brendan Williams is a former member of the Washington Legislature.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
