Healthcare Reform - State Based Universal Healthcare

December 19, 2022

Dec 19, 2022

Healthcare Reform

December 19, 2022

Mission

The Healthcare delivery system in the United States is a patchwork that leaves much to be desired. It is the most expensive system among the top 35 industrial countries and covers far fewer participants delivering lower levels of quality care than many of our peer nations. This blog will provide:

· Current problems in healthcare

· Actions you can take

· Background information on healthcare

· References.

Current State of Affairs

Universal healthcare has been proposed to more than 100 years for the United States. It is a policy that can make us more competitive at lower cost and provide higher quality better care than we have today. Yet we have a patchwork of systems where payers stand between doctors and patients and determine what kind of care, if any a patient can receive at ever increasing costs.

It is interesting to note that even a VP of Berkshire Hathaway was on Public Television asking for Universal Healthcare to make US industry competitive with the rest of the world, by providing higher quality healthcare at lower cost.

In each two-year Congress in the United States about 400 pieces of legislation are proposed to address something having to do with healthcare generally 4 pass.

Most of these bills are band-aids to address problems that have come to light in our patchwork system.

Some States are trying to pass Universal Healthcare themselves. Some of those are below. Resources are at the bottom of the newsletter.

Hawaii

Hawaii passed the Hawaii Pre Paid Healthcare Law in 1974. It mandated that employers provide healthcare coverage to employees who work 20 hours/week for 4 consecutive weeks. It has been the cornerstone legislation that ensures that Hawaii has one of the lowest uninsured rates in the US, about 5%.

In 1981 Congress passed ERISA (Employee Retirement Income Security Act). The language of the law was poor and subject to interpretation by the courts. What it meant to do was preclude states from modifying benefits when a company had employees in many states. Since Hawaii’s legislation was passed 7 years prior it was given a grandfather waiver from ERISA.

Oregon

“In 2019, the Oregon Legislative Assembly passed Senate Bill 770, which established the Task Force on Universal Health Care. The Task Force was charged with recommending a universal health care system that offers equitable, affordable, comprehensive, high quality, publicly funded health care to all Oregon residents. “1

They have finished their report and a link to it is in the references below.

The Oregon plan designs a system ready for implementation in 2026. There are no copays/deductibles. Every resident is covered. The state of Oregon will be the insurance company for people in Oregon. It will cost an estimated $980M less than is expended today and cover all residents in 2026. Employers and employees would pay premiums to the Oregon Fund as would some residents.

Required is still congressional action to allow Oregon to waive ERISA requirements and receive Medicare and Medicaid payments to make the system work.

There has been a statewide survey to determine if such as system has public support. I was surprised to see that many rightwing Republican business people in Eastern Oregon (red) were some of the strongest supporters. They need to provide healthcare to keep employees and Insurance companies are either withdrawing from Eastern Oregon or raising rates so high that it is hard for the companies to remain competitive.

Washington

Washington State’s initial plan was similar. Instead of receiving an up/down vote in the state legislature the state authorized the creation of a Universal Commission (like Oregon) to design an implementation plan. The commission’s baseline report was completed in November 2022. It contains a suite of recommendations for the transition to a Universal healthcare system. A link to the report is here https://www.hca.wa.gov/assets/program/commission-baseline-report-20221101.pdf

The nonprofit Whole Washington, who helped craft the original Universal Healthcare legislation, built a calculator so you can determine what your costs would be in a Washington Universal plan, https://wholewashington.org/how-we-pay-for-it/. Employers and employees generally find the proposed costs much lower than they pay now.

Waivers for Medicare, Medicaid and ERISA (Employee Retirement Income Security Act), are needed make state plans work. (ERISA does not allow states to force cross state employers to modify benefits (like healthcare).

What You Can Do

See resources below for your senator/representative

1. You can call or email your Senators and Representative and say

My name is _________, I am a constituent and live in zipcode ________.

We can all agree that we need better healthcare and this goes for mothers and children especially. Please work to pass the Momnibus collection of bills to improve maternal and child health.

Please work to pass Representative Ro Khanna’s “State-Based Universal Health Care Act of 2021” (HR 3775). It waives ERISA for any state building a universal health care system covering all their residents.

Background – Pay As You Go

Countries with universal healthcare chose to ask the question “How can everyone have healthcare?”. If you don’t ask the question you never get to the answer. That leads us to the fourth model of healthcare.

There is a fourth model for healthcare and it is called “Pay as You Go”. Much of the world uses this system. If you can afford to go to the doctor then you go and if not illnesses get worse. In some sense this can become an economic disaster. When workers are too sick to work then families starve. Economies need people to work and so there is a built in incentive for a healthy economy to make sure that everyone has access to healthcare.